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!
Seizure reduction can occur very soon after the ketogenic diet is initiated or it may take several months. During this time, it is important to remain committed to keeping the diet consistent and work with your keto diet team who will help you fine tune the diet to achieve the best seizure control. Commitment to consistency to the diet recommendations is important to determine effectiveness of the therapy in controlling seizures.
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.
About 20% of children on the ketogenic diet achieve freedom from seizures, and many are able to reduce the use of anticonvulsant drugs or eliminate them altogether. Commonly, at around two years on the diet, or after six months of being seizure-free, the diet may be gradually discontinued over two or three months. This is done by lowering the ketogenic ratio until urinary ketosis is no longer detected, and then lifting all calorie restrictions. This timing and method of discontinuation mimics that of anticonvulsant drug therapy in children, where the child has become seizure-free. When the diet is required to treat certain metabolic diseases, the duration will be longer. The total diet duration is up to the treating ketogenic diet team and parents; durations up to 12 years have been studied and found beneficial.
In other words, clinical data should be rolling in fairly soon, and that’s a good thing. In the meantime Dr. Seyfried and other advocates who so passionately believe that ketogenic diets will greatly help patients with brain cancer do no one any favors by claiming unequivocally that cancer is a metabolic disease and saying that ketogenic diets are more beneficial than chemotherapy for patients with brain tumors.
^ Ketogenic "eggnog" is used during induction and is a drink with the required ketogenic ratio. For example, a 4:1 ratio eggnog would contain 60 g of 36% heavy whipping cream, 25 g pasteurised raw egg, saccharin and vanilla flavour. This contains 245 kcal (1,025 kJ), 4 g protein, 2 g carbohydrate and 24 g fat (24:6 = 4:1). The eggnog may also be cooked to make a custard, or frozen to make ice cream.
In 2008, two randomized, controlled studies (one double-blinded) were published demonstrating that the ketogenic diet controlled seizures. In addition, a consensus statement from 26 dietitians and neurologists at worldwide ketogenic diet centers was published in Epilepsia to help guide clinical management of ketogenic diet patients. Lastly, the first international biannual ketogenic diet conference was held in Phoenix, Arizona to bring together researchers and clinicians. This conference has continued every other year.
Cardiovascular Disease – A ketogenic diet is often feared because of its high dependence on dietary fat for energy. This misguided fear is based on the outdated notion that eating fat negatively affects cardiovascular health, in particular, blood lipids. On the contrary, a low-carbohydrate ketogenic diet may actually improve blood lipid profiles, including decreased triglycerides and total and LDL cholesterol, and increased HDL cholesterol.39 40 41 A ketogenic diet might also alter the size and volume of the different LDL particles in a beneficial way, shifting from small, dense particles (believed to be atherogenic) to large, fluffy particles. 42 (See the Natural Grocers Customer Literature File Fats— Saturated for more information)
Similarly, in a 2015 study, mice receiving a combination of hyperbaric oxygen and dietary ketone supplementation showed a clear reduction in tumor growth rate and metastasis.20 Also, these mice lived twice as long as control animals. Based on these results, the study authors state that further investigation into the effectiveness of this combination therapy as a potential treatment for late-stage metastatic cancers is urgently required.
Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures, and kidney stones. The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone. About one in 20 children on the ketogenic diet develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone. The stones are treatable and do not justify discontinuation of the diet. Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in one-seventh of the incidence of kidney stones. However, this empiric usage has not been tested in a prospective controlled trial. Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:
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.
Leanne: I went to my naturopath, and she’s like this is awesome, this is exactly what we want to see. My issue was hormones, so I want cholesterol so that my body can build hormones, because without that cholesterol good luck. When I went to my regular GP, he was like “Statins, put you on statins. Oh my gosh it’s way too high.” What do you say to people, you’re saying 200 is always thrown out there with cholesterol. What you’re saying is that cholesterol is not really all that important in the grand scheme of things if you’re looking at your number. It’s more important to look at triglycerides in that ratio?
Aside from carb flu, be warned that staying in long-term, continuous ketosis may have drawbacks that may actually undermine your health and longevity. To stay on the safe side, I recommend undergoing a cyclic ketogenic diet. The "metabolic magic" that ketosis brings to the mitochondria actually occurs during the refeeding phase, not during the starvation phase.
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Jimmy Moore: The good news is even the dietary guidelines committee is acknowledging “oops, we got it wrong when it came to dietary cholesterol.” A lot of people haven’t heard this yet, because they haven’t released the full report but they now have backed away from limiting the amount of cholesterol that you consume in your diet. You know how eggs have always been vilified because of there cholesterol content? They’re now saying, “Okay it’s not dietary cholesterol that’s the enemy. Please start eating cholesterol again.” You still go into stores and “Cholesterol free food.” It’s a natural cholesterol. I’m going “Okay, so something is going to have to happen.” It is happening Leanne.
The ketogenic diet is not a benign, holistic, or natural treatment for epilepsy; as with any serious medical therapy, complications may result. These are generally less severe and less frequent than with anticonvulsant medication or surgery. Common but easily treatable short-term side effects include constipation, low-grade acidosis, and hypoglycaemia if an initial fast is undertaken. Raised levels of lipids in the blood affect up to 60% of children and cholesterol levels may increase by around 30%. This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and if persistent, by lowering the ketogenic ratio. Supplements are necessary to counter the dietary deficiency of many micronutrients.
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.
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A lifestyle of fasting may involve an individual eating for a period of only 4-8 hours in one day. A 20-hour fast may involve eating food between 3pm and 7pm each day. This regular intermittent fasting lifestyle allows the body to produce ketones in order to fuel the entire body. The 20-hour fast may be optimal for individuals with the diagnosis of cancer, but may otherwise be incorporated into your lifestyle using a 16 to 18 hour fasting period.
In order to be successful, this therapy calls for strict compliance and plenty of patience, especially in the beginning. Most important, patients with epilepsy should only use the diet with the support of a knowledgeable ketogenic diet team, including a doctor and a licensed dietitian who can correctly calculate and monitor the diet for each individual.
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.
Recent findings Although most preclinical studies indicate a therapeutic potential for ketogenic diets in cancer treatment, it is now becoming clear that not all tumors might respond positively. Early clinical trials have investigated ketogenic diets as a monotherapy and – while showing the safety of the approach even in advanced cancer patients – largely failed to prove survival prolonging effects. However, it gradually became clear that the greatest potential for ketogenic diets is as adjuvant treatments combined with pro-oxidative or targeted therapies initiated in early stages of the disease. Beneficial effects on body composition and quality of life have also been found.
I just got to know too that my Cholesterol raised a lot, I've been on keto for a little more than 3 months and before that always had a low carb diet. I don't know if the 3 day fast I did before taking the blood test only " aggravated" the situation. The total is 302, LDL is 214! But since the triglycerides are 94 and HDL 57, it seems to be OK. I read that a low rate of TG/HDL may indicate that the LDL particles are of the bigger, fluffier type less dangerous.
One study reported upon the effect of ketogenic diets on quality of life, cognition and behaviour. No difference was found in the quality of life of those following a ketogenic diet and the group receiving care as usual, but participants following the ketogenic diet were found to be more active, more productive and less anxious. More research is needed in these areas.
Instead of thinking about the total carbs you’re eating, assess what those carbs provide to you. Do the majority of your carbs come from fruit and vegetables, with a payload of fiber and disease-fighting antioxidants? Fantastic. Or are you consuming them in the form of added sugars (cookies, candy, soda) or refined flour? If you are, you know what to do.
For most children with epilepsy, medications are the primary treatment modality and provide good seizure control in over half of the children. However, more than 25 percent of children with epilepsy have either difficult-to-control seizures despite medications or suffer treatment-limiting side effects. Only a limited number of these children are candidates for surgical therapy to cure their epilepsy and their caregivers look for other options. Neurostimulation (vagus nerve stimulation or VNS) is one choice. Dietary therapy is another.
Animal data suggest a role for the ketogenic diet in protection against trauma and ischemia, as ketones may be a preferred fuel in the injured brain . Prins et al.  studied the role of the ketogenic diet in a controlled cortical impact model in rats. Young rats of varying postnatal ages underwent a small craniotomy and then, with the dura intact, were subjected to a standardized piston cylinder injury. Immediately after the impact, the rats started a standard diet or the ketogenic diet. After 1 week, a postmortem measurement of cortical contusion area was performed. The contusion area was significantly decreased in postnatal day-35 and day-45 rats that had been fed the ketogenic diet, but not in younger or older rats.
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.
First, I want to thank you for all of your dedication and work in providing this site. The difficulty of maintaining a healthy weight is a big problem for so many people. My personal question & issue in staying on Keto is my craving for fresh fruit. This a.m I had a large fresh peach along with my “Bullet Proof” coffee. Have I now sabotaged today’s Keto eating?
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.
3. The Low Glycemic Index Treatment (LGIT, uses a liberalized but still low carbohydrate intake, with carbohydrates supplied only in the form of low-glycemic index foods (glycemic index of less than 50 relative to glucose). Of the 20 patients initially studied on this diet in 2005, 10 experienced a greater than 90% reduction in seizure frequency. The LGIT can be started as an outpatient without a fasting period. An updated study in 2009 included 76 children, of which 50% of those remaining on the diet at 3 months had a >50% seizure reduction.
High levels of triglycerides in the blood are thought to be a sign of poor metabolism. Poor metabolism, or metabolic disorders, are associated with obesity, diabetes, heart disease and cancer. Often times, elevated triglycerides are a byproduct of insulin resistance. In these cases, a ketogenic diet is an excellent strategy to improve those numbers.
Gluconeogenesis is the endogenous production of glucose in the body, especially in the liver primarily from lactic acid, glycerol, and the amino acids alanine and glutamine. When glucose availability drops further, the endogenous production of glucose is not able to keep up with the needs of the body and ketogenesis begins in order to provide an alternate source of energy in the form of ketone bodies. Ketone bodies replace glucose as a primary source of energy. During ketogenesis due to low blood glucose feedback, stimulus for insulin secretion is also low, which sharply reduces the stimulus for fat and glucose storage. Other hormonal changes may contribute to the increased breakdown of fats that result in fatty acids. Fatty acids are metabolized to acetoacetate which is later converted to beta-hydroxybutyrate and acetone. These are the basic ketone bodies that accumulate in the body as a ketogenic diet is sustained. This metabolic state is referred to as "nutritional ketosis." As long as the body is deprived of carbohydrates, metabolism remains in the ketotic state. The nutritional ketosis state is considered quite safe, as ketone bodies are produced in small concentrations without any alterations in blood pH. It greatly differs from ketoacidosis, a life-threatening condition where ketone bodies are produced in extremely larger concentrations, altering blood ph to acidotic a state.
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For most people, a ketogenic diet leads to improvements in cholesterol, but there are sometimes transient rises in cholesterol levels during weight loss. During rapid weight loss, cholesterol that you had stored in your adipose tissue (ie, body fat) is mobilized, which will artificially raise serum LDL as long as the weight loss continues. To avoid being misled by this, the best time to check blood lipids is a couple of months after weight loss ceases. Total cholesterol includes HDL (the so called ‘good cholesterol’), which usually goes up 10-15% on a ketogenic diet. That said, some people have high calculated LDL cholesterol values even after weight loss stops. If this occurs, you should discuss further diagnostic tests with your doctor. Current research is looking at LDL cholesterol as a mix of different particle sizes, where the small ones are dangerous and the larger ones are not. With a well-formulated ketogenic diet, we see a shift away from the small dangerous LDL even when the total LDL goes up.
Dr. Vincent M. Pedre, medical director of Pedre Integrative Health and president of Dr. Pedre Wellness, is a board-certified internist in private practice in New York City since 2004. His philosophy and practices are a blend of both Western and Eastern medical traditions. He is a clinical instructor in medicine at the Mount Sinai School of Medicine and is certified in yoga and medical acupuncture. His unique methodology is best described as integrative or defined by a functional, systems-based approach to health. With his holistic understanding of both sides of the equation, he can help each patient choose the best course of action for their ailments to provide both immediate and long-term relief. His holistic approach incorporates positive, preventive health and wellness lifestyle choices. Dr. Pedre Wellness is a growing wellness platform offering health-enhancing programs along with informative social media and lifestyle products, such as dietary supplements, books, and weight-loss programs.
Also, consider supplementing with the amino acid leucine, as it can be broken down directly into acetyl-CoA, making it one of the most important ketogenic amino acids in the body. While most other amino acids are converted into glucose, the acetyl-CoA formed from leucine can be used to make ketone bodies. It’s also present in keto friendly foods like eggs and cottage cheese.