People use a ketogenic diet most often to lose weight, but it can help manage certain medical conditions, like epilepsy, too. It also may help people with heart disease, certain brain diseases, and even acne, but there needs to be more research in those areas. Talk with your doctor first to find out if it’s safe for you to try a ketogenic diet, especially if you have type 1 diabetes.
Let’s go back to the research assessing how the low-carb, high-fat diets such as the ketogenic diet affect your LDL levels. In the meta-analysis by Bueno et al., low-carb diets were shown to increase HDL twice as much as low-fat diets after randomized controlled interventions. It also showed that there was a small increase in LDL-C in low-carb subjects compared to low-fat diet subjects who experienced no increase.
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.

A small Feb. 20, 2017, study looked at the impact of a six-week ketogenic diet on physical fitness and body composition in 42 healthy adults. The study, published in the journal Nutrition & Metabolism, found a mildly negative impact on physical performance in terms of endurance capacity, peak power and faster exhaustion. Overall, researchers concluded, “Our findings lead us to assume that a [ketogenic diet] does not impact physical fitness in a clinically relevant manner that would impair activities of daily living and aerobic training.” The “significant” weight loss of about 4.4 pounds, on average, did not affect muscle mass or function.
Ive been strict keto for over 3 months and have lost 20lbs. I got my test results back yesterday and was shocked to see how my levels had changed: total cholesterol went from 230 to 308!! All the bad went up and all the good went down. But I’ve also heard that it can take a bit longer for cholesterol levels to even out and start going down. Is this true? I don’t want to quit keto because I have another 20lbs to lose, but I don’t want to have a stroke either.
Cancer cells demonstrate increased glucose metabolism compared with normal cells, with a shift toward lactic acid production despite the presence of oxygen, a mechanism also referred to as the Warburg effect.1,2 Glucose is an important precursor to mitochondrial respiration, which results in the production of energy as ATP. In normal cells, the ultimate conversion of glucose to ATP requires the presence of oxygen; if oxygen is not present, lactic acid is produced. Cancer cells, however, convert glucose to lactic acid in the presence of oxygen.2 In addition, cancer cells harbor mitochondrial DNA mutations that result in impaired mitochondrial respiration. Therefore, cancer cells require a large amount of glucose to satisfy their energy needs.
The ketogenic diet has many potential effects and is likely to have different mechanisms in different diseases [8]. In metabolic conditions, cancer, trauma, and ischemia, the ketogenic diet may confer a protective effect by providing an additional energy substrate to tissue at risk of cell death. However, ketosis may have more complicated effects. In one model, rats fed the ketogenic diet show marked upregulation of both the ketone transporter and the glucose transporter type 1 (GLUT-1), promoting the influx of nutrients into the brain [9]. These authors provided evidence that the ketogenic diet increases capillary density without increasing overall blood flow, providing a way that the diet may help nourish tissue at risk. This finding is particularly interesting in light of findings in animals with tumors, in which the diet is associated with an anti-angiogenic effect [10,11]. These discordant results eventually will need to be reconciled; they may be due to differences in angiogenic stimuli in normal cells versus malignant cells.
Another group at increased CVD risk are those with one or two copies of the apoE4 allele (gene). These individuals tend to have higher VLDL cholesterol but lower HDL cholesterol. In addition to heart disease, they have greater risk for Alzheimer's disease, cancer and other diseases (9). The Apo-E4 forums provide helpful information, guidance and support for those with the apoE4 allele.
HDL is still low and stuck on 45 even after hoping strongly with more healthy saturated fats organic bone broth from lamb bones, etc. LDL way up 170 and triglycerides a a record high of 170, Non HDL choleseterol at 203. Kinda surprizd I cannot more that HDL number aftyer all the keto stuff. And unsure why the LDL has exploded since stress has always been with me these last 9 years.
Cholesterol serves a number of important roles in the body. First of all, cholesterol is a critical structural element in certain tissues such as our brain and nervous system. In fact, it is estimated that around 25% of our cholesterol can be found in the brain. Just to highlight our failed fat philosophy over the years, higher saturated fat intake and high cholesterol levels are associated with better mental function in old age (1)!
I have pancreatitis, well controlled, which is the way I want to keep it. The biggest difficulty I have with keto is this: I eat a small portion of steel cut oats in the morning. When I don’t, within two days , I start having bleeding, dark in colour. My endrocrinolagest feels that I need the roughage in the steel cut oats to replete the bowel lining. I have great difficulty loosing weight, always have, even though I eat very clean, no junk food, never eat out, don’t like pop, don’t crave sugar, cook all food fresh. Any comment? Willing to try anything you can suggest.
The ketogenic diet is a natural, nontoxic metabolic therapy being studied and utilized for cancer prevention and treatment. It works because cancer cells are dependent upon a constant supply of blood sugar (glucose) to stay alive. Normal cells can make energy from both glucose and ketones (metabolic by-products of burning fat), but most cancer cells can only use glucose. Avoiding carbohydrates (starch and sugar) while enjoying delicious and healthy protein and fats will lower blood glucose and increase blood-ketone levels, resulting in a normal body state called nutritional ketosis. Research has shown that nutritional ketosis starves cancer cells while nourishing normal cells and strengthening total body health.
The understanding of the mechanisms of action of KD is incomplete; however, some theories have been advanced about how it modifies the neuronal metabolism and excitability in order to reduce the seizure frequency. Possibly, the real mechanism of reduction of cortical hyperexcitability involves multiple factors. Some of the systems involved in seizure reduction are related to metabolic changes in the blood and cerebrospinal fluid (CSF), including a decrease in glucose levels and an increase in KB. The mitochondria function and energy reserve may also play a role in the KD mechanisms, resulting in synapse stabilization and excitatory decrease.
Jimmy Moore: That’s a loaded question and we could probably go 3 hours just on that but I’ll give you the nut shell. Most medical professionals have been taught to look at 2 primary numbers on your cholesterol panel. Total cholesterol, and this number called LDLC, which is your LDL cholesterol that you’ve heard about. You’ve heard LDL is bad and you’ve heard if you’re total cholesterol level is over 200, oh my god you are at great risk for heart disease. Exactly.
One potential confounder of ketogenic diet studies is another direct effect of the diet—increased levels of fatty acids. Dietary supplementation of essential fatty acids can improve cognitive dysfunction, including in patients with AD [44, Class II]. This suggests that something other than ketone bodies (in this case, essential fatty acids) may have beneficial effects in neurodegenerative diseases. Essential fatty acids may have a beneficial effect on learning in rodent models, raising the possibility that they may have neuromodulatory properties of their own [45,46]. 

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?
The precise mechanisms behind the physiological effects of the ketogenic diet and ketones are not fully understood. It is believed that the ketogenic diet is anti-inflammatory, that it decreases free radical production while enhancing production of the body’s own natural anti-oxidants, and it improves metabolic efficiency.8 9 10 11 12 Specific conditions a ketogenic diet may benefit include:
Pattern B LDL, on the other hand, has a much smaller particle size and is much more prone to oxidation. Another thing about pattern B LDL is that it is small enough to enter into the endothelial lining of the artery where it can become oxidized and more likely to form plaque.  There is a high association between these small dense particles and cardiovascular disease.
Eliminating several food groups and the potential for unpleasant symptoms may make compliance difficult. An emphasis on foods high in saturated fat also counters recommendations from the Dietary Guidelines for Americans and the American Heart Association and may have adverse effects on blood LDL cholesterol. However, it is possible to modify the diet to emphasize foods low in saturated fat such as olive oil, avocado, nuts, seeds, and fatty fish.
Solomon L. Moshe, MD. Professor of Neurology, Neuroscience and Pediatrics, Director of Clinical Neurophysiology and Child Neurology at Albert Einstein College of Medicine, Bronx, New York; past president of the American Epilepsy Society. William R. Turk, MD. Division Chief, Department of Pediatrics, Division of Neurology, The Nemours Children's Clinic, Jacksonville, Florida.
Tumors have hypoxic zones and normoxic (aerobic) zones, with a symbiotic relationship between the two. Hypoxic cancer cells derive energy from fermentation of glucose, and secrete lactate. Normoxic cancer cells prefer and attract lactate as fuel for the TCA cycle, sparing glucose for the hypoxic cells. [NCBI, “Tumor cell metabolism: an integral view”]
While dietary saturated fat and cholesterol do not impact blood cholesterol levels in most people, they may raise total and LDL cholesterol in a subset of the population referred to as “hyper-responders.” If you are a hyper-responder (this is something you’ll need to determine with the help of your doctor), I recommend following a Mediterranean Paleo-style diet, an approach that is lower in fat and higher in Paleo-friendly carbohydrates, rather than a ketogenic diet.
The mainstay of treatment for epilepsy is pharmaceutical intervention. As I recently noted, more and more we are seeing surgical procedures being performed for those individuals who have not had a significant improvement with drugs. I indicated that at least some individuals are gluten sensitive and may benefit from a gluten-free diet which potentially could keep them from undergoing potentially life-threatening surgery as a treatment for their epilepsy.
As mentioned above, sometimes a rise in LDL cholesterol is temporary, especially during weight loss. However, if yours remains very high and especially if you have additional risk factors (family history of heart disease, certain genetic markers, diabetes, or smoking), you may want to look into having the some advanced testing performed. They may give a clearer indication of your risk profile and state of health, compared to conventional blood cholesterol levels alone:
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.
A popular keto supplement are exogenous ketones (popularly called “keto diet pills”) that may help you achieve results earlier as well as remain in that state. (Don’t confuse exogenous ketones with raspberry ketones, as the latter don’t raise ketone levels in the body or mimic endogenous ketones, so you wouldn’t use raspberry ketones in your regimen.)
Dr. Gonzalez wrote an eight part article series for Natural Health 365 on the history and failure of the ketogenic diet for cancer. Dr. Gonzalez’s nutritional cancer treatment expertise is much deeper than ANYONE currently promoting the ketogenic diet for cancer, because unlike anyone else promoting it, he actually treats cancer patients with nutrition every day.
But there are some cancer biologists out there that feel that while mutations are ubiquitous in cancer, they may not be the primary driving force of the disease and, as we’ll discuss later, they may actually be secondary effects of a deeper underlying process. They believe that cancer is as much a disorder of altered energy metabolism or energy production as it is genetic damage. This goes back to the work of German physician Otto Warburg in the 1920s and 1930s, and we know that healthy cells generate energy using an oxygen-based process of respiration. This is what we refer to as cellular respiration, but Warburg was the first to note that cancer cells prefer an anaerobic, or oxygen-free, process of producing cellular energy known as fermentation.
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.
Often caused by lymph node removal or damage due to cancer treatment, lymphedema occurs because there’s a blockage in the lymphatic system and results in the swelling in leg or arm. A 2017 study involved patients who suffered from obesity and lymphedema and who embarked on a 18-week ketogenic diet. Weight and limb volume was significantly reduced. (5)
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.
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.
The ketogenic diet is designed to allow an individual to feel satisfied easily as a result of optimal insulin and leptin sensitivity. For example, a man weighing 150 pounds should consume 30-50g/day of carbohydrates and less than 70g/day of protein to maintain an optimal state of ketosis. When only a single meal or two is consumed consisting of approved ketogenic foods, this is easy. The ideal blood sugar concentration for weakening cancer cells is between 60-70mg/dl, and ketone levels are recommended between 4-7mM.
The CKD is rich in lipids (90%) and low in carbohydrates and protein, in order to produce ketosis, and simulates a starvation state. It is a rigid diet, mathematically and individually calculated, and medically monitored (Armeno et al., 2014). It must also provide adequate vitamins and minerals. The shift in the energy metabolism from glycolytic energy production to energy generation through oxidative phosphorylation (fatty acid b-oxidation and ketone-body production) is part of the anticonvulsant mechanism of the KD (Bough, 2008; Liu et al., 2018). This is discussed in more detail in the section on the mechanism of action.
There’s less research, as I mentioned before, in humans, but the little that does exist, I think, is promising and should lead us to doing more. One study monitored tumor growth in response to a high-carb versus a ketogenic diet in 27 patients with cancer of the digestive tract. Tumor growth increased by 32.2 percent in patients who received the high-carb diet, but actually decreased by 24.3 in the patients on ketogenic diet. However, in this study, the difference was not statistically significant. That’s a whole other discussion about statistical significance that I won’t go into here, but that’s one potential reason to take that study with a grain of salt.
Preclinical evidence indicating the effect of a KD on tumor growth and progression. The bar chart shows the number of preclinical studies, which investigated the effect of a KD on different types of cancer. Colors of the bars represent the result of each study as indicated in the color key. Studies on KD and cancer were collected by a literature search covering through the end of 2017. R indicates studies with a calorie-restricted KD; T indicates use of a KD as an adjuvant therapy to classic therapy.
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.
In adults, the type of ketogenic diet typically used is the modified Atkins diet. Carbohydrates are limited to 20 grams per day and the intake of foods containing fat is required to get into the state of ketosis. For example, foods such as heavy cream, oils, avocado, eggs, butter and meats are encouraged; whereas conventional breads, pastas, cereals and cakes are restricted.
When you first embark on a ketogenic diet, your goal is to be in nutritional ketosis consistently. Over time, as you train your body to function on fewer carbohydrates, you may enter the fat adaptation phase. While ketosis can be achieved after just a few days of the diet, at least three to four weeks of strict adherence to the diet is required in order to reach the fat adaptation state. This is also the time frame during which you’ll likely begin to notice benefits of the diet.
Leanne: For those of you guys who don’t know Jimmy Moore, first of all you’ve probably been living under a rock because this guy’s huge. Excited to have you here on the show today. Jimmy busted on health scene in 2004 after a phenomenal 180 pound weight loss that enabled him to come off of his prescription drugs for high cholesterol, high blood pressure, and respiratory problems. He is the co-author of Cholesterol Clarity, Keto Clarity, and the energetic personality behind the blog Living La Vida Low Carb at www.livinlavidalowcarb.com, and the voice of the top ranked podcast The Livin’ La Vida Low Carb show. He’s interviewed over 900 of the world’s top health experts, I’m pretty sure I’ve listed to at least 400 of those.

In my previous articles, I discussed my friend, the late Dr. Robert Atkins, the famed diet doctor, who long before Dr. Seyfried appeared on the scene hoped his “ketogenic” diet might be an answer to cancer. During the late 1980s and right through most of the 1990s, Dr. Atkins treated hundreds of cancer patients, many, though not all, with a ketogenic diet, along with a variety of supplements and intravenous vitamin C. 
×