Because it lacks carbohydrates, a ketogenic diet is rich in proteins and fats. It typically includes plenty of meats, eggs, processed meats, sausages, cheeses, fish, nuts, butter, oils, seeds, and fibrous vegetables. Because it is so restrictive, it is really hard to follow over the long run. Carbohydrates normally account for at least 50% of the typical American diet. One of the main criticisms of this diet is that many people tend to eat too much protein and poor-quality fats from processed foods, with very few fruits and vegetables. Patients with kidney disease need to be cautious because this diet could worsen their condition. Additionally, some patients may feel a little tired in the beginning, while some may have bad breath, nausea, vomiting, constipation, and sleep problems.

The keto diet works for such a high percentage of people because it targets several key, underlying causes of weight gain — including hormonal imbalances, especially insulin resistance coupled with high blood sugar levels, and the cycle of restricting and “binging” on empty calories due to hunger that so many dieters struggle with. In fact, these are some of the direct benefits of the keto diet.


On a “strict” (standard) keto diet, fats typically provides about 70 percent to 80 percent of total daily calories, protein about 15 percent to 20 percent, and carbohydrates just around 5 percent. However, a more “moderate” approach to the keto diet is also a good option for many people that can allow for an easier transition into very low-carb eating and more flexibility (more on these types of plans below).

To make sure the diet is nutritionally balanced, an experienced dietitian works out exactly how much of which foods the person can eat each day. To help with this, people have individual recipes, are given support on how to plan meals, and are guided on which foods should be avoided. As the diet can be quite restrictive, the dietitian will recommend any vitamin and mineral supplements that are needed.
Despite what we’ve all heard, there’s actually no such thing as “good” or “bad” cholesterol; there is only one type of cholesterol. Your LDL and HDL values refer to how much cholesterol is carried in your HDL and LDL lipoprotein particles. In fact, the same cholesterol is continuously transferred among these and other types of lipoproteins as they make their way through the bloodstream.
Essentially, the keto diet for beginners works by “tricking” the body into acting as if its fasting (while reaping intermittent fasting benefits), through a strict elimination of glucose that is found in carbohydrate foods. Today the standard keto diet goes by several different names, including the “low-carbohydrate” or “very-low-carbohydrate ketogenic diet”(LCKD or VLCKD for short).
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.
By contrast, some people have seen their total, HDL and LDL cholesterol levels increase anywhere from 50% to 200% or more after switching to a low-carb or keto diet. Although a few are overweight or metabolically unhealthy, many of these individuals belong to a group that Dave Feldman at Cholesterol Code calls Lean Mass Hyper-responders (LMHRs): healthy, thin and/or athletic people with LDL cholesterol values of 200 mg/dL (5.2 mmol/L) or higher.
The glowing TV stories followed, including a memorable prime time, one-hour special about the subject on ABC hosted by the late Peter Jennings. The other networks, in quick succession, picked up the cause. However, not too long after, word broke that Times’ reporter Kolata had been, through her agent, hawking to publishers an idea for a book about anti-angiogenesis and cancer.

Leftovers will be another thing we will take into consideration. Not only is it easier on you, but why put yourself through the hassle to cook the same food more than once? Breakfast is something I normally do leftover style, where I don’t have to worry about it in the morning and I certainly don’t have to stress about it. Grab some food out the fridge, pre-made for me, and head out the door. It doesn’t get much easier than that, does it?


Determining who will respond well to KD is a topic still ripe for research. Researchers have previously explored the use of electroencephalogram, but results from a recent study were not statistically signifigant.3 Other studies have explored a patient’s preference for certain foods, but neither have been very effective strategies to determine the success of KD.
Initial studies indicate that the ketogenic diet appears effective in other metabolic conditions, including phosphofructokinase deficiency and glycogenosis type V (McArdle disease). It appears to function in these disorders by providing an alternative fuel source. A growing body of literature suggests the ketogenic diet may be beneficial in certain neurodegenerative diseases, including Alzheimer disease, Parkinson’s disease, and amyotrophic lateral sclerosis. In these disorders, the ketogenic diet appears to be neuroprotective, promoting enhanced mitochondrial function and rescuing adenosine triphosphate production.
Sign up 24 hours before the general public and increase your chances of getting a spot. We only open the certification program twice per year. Due to high demand, spots in the program are limited and have historically sold out in a matter of hours. But when you sign up for the presale list, we’ll give you the opportunity to register a full 24 hours before anyone else.
In some ways, it’s similar to the Atkins diet, which similarly boosts the body’s fat-burning abilities through eating only low-carb foods, along with getting rid of foods high in carbs and sugar. Removing glucose from carbohydrate foods will cause the body to burn fat for energy instead. The major differences between the classic keto and the Atkins diet is the former emphasizes healthier keto fats, less overall protein and no processed meat (such as bacon) while having more research to back up its efficacy.

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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.
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]
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.)
Dr. Luis Caicedo, a pediatric gastroenterologist and director of the Fecal Microbiota Transplant Program at Nicklaus Children's Hospital in Miami, who was not involved in the study, called the research "very exciting." It "opens the door for more investigations… and certainly gives you more data on why this ketogenic diet works so [well]" for epilepsy, Caicedo said.
Patients diagnosed with the immune based “blood cancers” like leukemia, lymphoma, and myeloma, as well as the sarcomas, a type of connective tissue malignancy, required a lower carb, high animal fat, moderate animal protein diet. Other patients, usually with problems other than cancer, thrived on a more “balanced” diet, incorporating a variety of plant and animal foods.
The Ketogenic Diet (KD) is a modality of treatment used since the 1920s as a treatment for intractable epilepsy. It has been proposed as a dietary treatment that would produce similar benefits to fasting, which is already recorded in the Hippocratic collection. The KD has a high fat content (90%) and low protein and carbohydrate. Evidence shows that KD and its variants are a good alternative for non-surgical pharmacoresistant patients with epilepsy of any age, taking into account that the type of diet should be designed individually and that less-restrictive and more-palatable diets are usually better options for adults and adolescents. This review discusses the KD, including the possible mechanisms of action, applicability, side effects, and evidence for its efficacy, and for the more-palatable diets such as the Modified Atkins Diet (MAD) and the Low Glycemic Index Diet (LGID) in children and adults. 

On a “strict” (standard) keto diet, fats typically provides about 70 percent to 80 percent of total daily calories, protein about 15 percent to 20 percent, and carbohydrates just around 5 percent. However, a more “moderate” approach to the keto diet is also a good option for many people that can allow for an easier transition into very low-carb eating and more flexibility (more on these types of plans below).
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.
Additionally, they are composed of higher lipid and lower protein content than LDL. Because of their physical properties and functional purposes, VLDL particles are more likely than other lipoproteins to clog vessels and impair vascular functions. Research studies have noted that high levels of VLDL are associated with increased risk of artherosclerosis and cardiovascular diseases. [20] VLDL is also considered to be a more precise indicator than LDL-C for a variety of metabolic conditions. [21]
The ketogenic diet’s origin dates back to the 1920s when doctors began using it to control seizures among patients with epilepsy. The history of the ketogetnic diet began with a nutritional plan made of carbohydrates (carbs), fat, and protein forces the body to use fat instead of carbohydrates for energy. Dubbed ketosis, this process creates two acids in the blood, ketones and decanoic acid, that our bodies and brains use for fuel.
More specifically, subjects in the lowest third of carbohydrate consumption had an HDL concentration of 1.21 mmol/L while subjects in the highest third had HDL concentration of 1.08 mmol/L. [13] According to the authors, “every 100-g/d increment of carbohydrate (approximately the difference between the top and bottom tertiles) was associated with 0.15-mmol/L less of HDL.” [13]
How can a ketogenic diet help with IBS and GERD? By significantly reducing dietary carbohydrate load, a ketogenic diet provides less fermentable substrate for gut bacteria, reducing the amount of gas produced in the small intestine. Several small studies indicate that a ketogenic diet improves abdominal pain, stool frequency, and reflux in patients with IBS-D and GERD, respectively. (30, 31) However, it is important to note that the long-term effects of a low-fermentable-carbohydrate diets, including the ketogenic diet, on gut bacteria remain to be seen. Our beneficial gut bacteria also require fermentable carbohydrates to survive, so it’s possible that the ketogenic diet could reduce their numbers. This is why I highly recommend following a cyclic ketogenic diet rather than a long-term, strict ketogenic diet. I’ll provide more information on that topic shortly.

In his books and in his office working with his own patients, Dr. Atkins warned that to reap the benefits of his diet, one must reach and stay in a state of ketosis, much like the traditional Eskimos. Even a slight deviation from the diet, some ill-advised cheating with a cookie or candy, could stop ketosis in its tracks, and with it, the value of the diet.

Of course, we know that genes alone are not responsible for cancer because we share many of the same genes as our hunter–gatherer ancestors and even just the same genes as our ancestors several generations ago, and yet the rate of cancer keeps going up. It’s expected to overtake cardiovascular disease as the number one cause of death in the U.S. fairly soon, and so that can’t be explained by genes alone.


Despite these associations between high concentrations of LDL particles and heart disease, research has consistently shown that keto diets help reduce heart disease risk factors in people with diabetes and other insulin-resistant conditions. Granted these are not outcome trials, showing an actual reduction in heart attacks, but those trials simply don’t exist one way or the other. Yet the reduction in risk factors certainly suggests that we may eventually see those beneficial results.
“Net carbs” and “impact carbs” are familiar phrases in ketogenic diets as well as diabetic diets. They are unregulated interchangeable terms invented by food manufacturers as a marketing strategy, appearing on some food labels to claim that the product contains less “usable” carbohydrate than is listed. [6] Net carbs or impact carbs are the amount of carbohydrate that are directly absorbed by the body and contribute calories. They are calculated by subtracting the amount of indigestible carbohydrates from the total carbohydrate amount. Indigestible (unabsorbed) carbohydrates include insoluble fibers from whole grains, fruits, and vegetables; and sugar alcohols, such as mannitol, sorbitol, and xylitol commonly used in sugar-free diabetic food products. However, these calculations are not an exact or reliable science because the effect of sugar alcohols on absorption and blood sugar can vary. Some sugar alcohols may still contribute calories and raise blood sugar. The total calorie level also does not change despite the amount of net carbs, which is an important factor with weight loss. There is debate even within the ketogenic diet community about the value of using net carbs.
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.

Because epilepsy is a metabolic disease (Clanton et al., 2017), interest in studies of alterations of metabolism by anticonvulsants such as the KD has increased, as has their importance for the treatment of drug-resistant epilepsy. This contribution reviews the use and effects of the KD and its variants for the treatment of adults and children with intractable epilepsy.
A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed, 24% occasionally prescribed the diet as a last resort, 24% had only prescribed the diet in a few rare cases, and 16% had never prescribed the diet. Several possible explanations exist for this gap between evidence and clinical practice.[34] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[31]
There is not one “standard” ketogenic diet with a specific ratio of macronutrients (carbohydrates, protein, fat). The ketogenic diet typically reduces total carbohydrate intake to less than 50 grams a day—less than the amount found in a medium plain bagel—and can be as low as 20 grams a day. Generally, popular ketogenic resources suggest an average of 70-80% fat from total daily calories, 5-10% carbohydrate, and 10-20% protein. For a 2000-calorie diet, this translates to about 165 grams fat, 40 grams carbohydrate, and 75 grams protein. The protein amount on the ketogenic diet is kept moderate in comparison with other low-carb high-protein diets, because eating too much protein can prevent ketosis. The amino acids in protein can be converted to glucose, so a ketogenic diet specifies enough protein to preserve lean body mass including muscle, but that will still cause ketosis.

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.


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.
The body needs bile to break down and digest dietary fat, and the gallbladder is responsible for storing bile before its release into the small intestine. Removal of the gallbladder and gallbladder disease cause fat malabsorption and may make it difficult to follow a ketogenic diet. If you have had your gallbladder removed or have existing gallbladder disease, consult with your doctor before trying a ketogenic diet.
In talking with my patients, a major part of epilepsy they struggle with most is the lack of control. They worry about going out in public and suddenly having a seizure — there’s just no predictability to it whatsoever, and I think that causes major anxiety. A diet is something in their environment they can control. They can be in control of their treatment and seizures, and I think that empowers them.
In the 1960s, medium-chain triglycerides (MCTs) were found to produce more ketone bodies per unit of energy than normal dietary fats (which are mostly long-chain triglycerides).[15] MCTs are more efficiently absorbed and are rapidly transported to the liver via the hepatic portal system rather than the lymphatic system.[16] The severe carbohydrate restrictions of the classic ketogenic diet made it difficult for parents to produce palatable meals that their children would tolerate. In 1971, Peter Huttenlocher devised a ketogenic diet where about 60% of the calories came from the MCT oil, and this allowed more protein and up to three times as much carbohydrate as the classic ketogenic diet. The oil was mixed with at least twice its volume of skimmed milk, chilled, and sipped during the meal or incorporated into food. He tested it on 12 children and adolescents with intractable seizures. Most children improved in both seizure control and alertness, results that were similar to the classic ketogenic diet. Gastrointestinal upset was a problem, which led one patient to abandon the diet, but meals were easier to prepare and better accepted by the children.[15] The MCT diet replaced the classic ketogenic diet in many hospitals, though some devised diets that were a combination of the two.[10]
Other genetic disorders caused by mutations limit the availability of energy substrates but do not necessarily cause seizures. One such disease is phosphofructokinase (PFK) deficiency. PFK is the rate-limiting enzyme in glycolysis for the conversion of fructose-6-phosphate to fructose-1,6-bisphosphate. Patients with mutations in the muscle isoform of PFK demonstrate exercise intolerance with myalgias and stiffness. There also are rare infantile forms, such as a case reported by Swoboda et al. [21, Class III], with myopathy and arthrogryposis. This patient displayed marked gains in muscle strength and improvement in his developmental milestones after being placed on the ketogenic diet.
On a “strict” (standard) keto diet, fats typically provides about 70 percent to 80 percent of total daily calories, protein about 15 percent to 20 percent, and carbohydrates just around 5 percent. However, a more “moderate” approach to the keto diet is also a good option for many people that can allow for an easier transition into very low-carb eating and more flexibility (more on these types of plans below).
If you have a history of hypothyroid issues, you may also struggle with unhealthy cholesterol levels as well — and the keto diet can make them even worse. However, for those of you who are being treated for your hypothyroid condition or who have an autoimmune thyroid condition, you may be able to follow the keto diet without any problems. In fact, many keto dieters with autoimmune thyroid conditions have found that the keto way of eating improved their quality of life more than any other diet.
The good news, however, is that following a well-formulated ketogenic diet should help increase HDL while lowering triglyceride levels. LDL will likely remain the same or potentially increase in order to efficiently transport triglycerides to cells to metabolize for energy. Again, LDL will likely become more of the pattern A type which is a highly beneficial shift.
Before starting the diet, the patient should maintain a seizure diary to establish a frequency parameter. Also needed are a laboratory evaluation including selenium and carnitine levels (Table 5), electroencephalogram (EEG), and a magnetic resonance image (MRI) of the brain. A renal ultrasound should be done in case of kidney stones; an electrocardiogram and carotid ultrasound are considered optional (Kossoff et al., 2018). The nutritional evaluation includes a nutritional anamnesis including a 3-day food report, food habits, allergies, aversions, and intolerances. Baseline weight, height, and the ideal weight for stature and body mass index (BMI) are needed to calculate the ketogenic ratio, calories, and fluid intake. The diet formulation should be established according to the patient’s age and the administration route (Kossoff et al., 2009).
Uh, no. Not exactly. Preclinical experiments are intriguing but fairly limited in applicability, and the case reports demonstrate nothing of the sort. There’s more to Dr. Seyfried’s hypothesis, for example, his idea that metastatic cancer comes about because of alterations in glutamine metabolism, but unfortunately he appears to misunderstand the genetics of metastasis when he bases part of his conclusion on observations that metastatic cancers often have the same genetic derangements as the primary tumor. It’s been a longstanding question whether clones of tumor cells possess the ability to metastasize as an intrinsic part of the process of becoming cancer cells or whether they acquire it later. Given that evolution is a major force driving cancer cells to become more invasive and that tumors are very heterogeneous, full of lots of different clones with different sets of genetic mutations, Dr. Seyfried’s hypothesis is at best simplistic. Also disappointingly, the evidence for any diet as a treatment for cancer is weak at best.

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.

Feldman believes that his findings thus far demonstrate that the combination of higher energy demands, lower body fat stores, and lower glycogen stores in LMHRs trigger increased production of LDLs for the purpose of carrying energy (triglycerides) to cells that need them, with cholesterol mainly along for the ride but also used by the cells for repair and other purposes, as needed.


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]

Around this time, Bernarr Macfadden, an American exponent of physical culture, popularised the use of fasting to restore health. His disciple, the osteopathic physician Dr. Hugh William Conklin of Battle Creek, Michigan, began to treat his epilepsy patients by recommending fasting. Conklin conjectured that epileptic seizures were caused when a toxin, secreted from the Peyer's patches in the intestines, was discharged into the bloodstream. He recommended a fast lasting 18 to 25 days to allow this toxin to dissipate. Conklin probably treated hundreds of epilepsy patients with his "water diet" and boasted of a 90% cure rate in children, falling to 50% in adults. Later analysis of Conklin's case records showed 20% of his patients achieved freedom from seizures and 50% had some improvement.[10]
Having first read Dr. Price’s book during my journalism days, I knew that according to his exhaustive work, humans were a varied species, in the past living in and adapting to all ecological niches excepting the Antarctic, offering a variety of food sources. To me, his work offered a solution to the conflicting dietary advice even then being offered to the world. It didn’t make sense as Nathan Pritikin insisted or as Bob Atkins argued, that all humans should follow one specific type of diet: It just didn’t seem reasonable, to me at least.
A randomised, controlled clinical trial among 120 overweight adults with high levels of cholesterol compared the effects of a ketogenic diet against a low-fat diet. After 24 weeks, the group following the keto diet reported greater weight loss and declines in the triglyceride levels and higher increases in the HDL cholesterol levels compared to the low-fat group (11).

Feel free to practice cyclical ketosis (maybe doing a ketogenic diet five days a week and going higher in healthy carbs the other two days) or whatever works for you. I’ve never heard an expert say you should be in ketosis 24/7, and militantly sticking with this plan can ultimately stall your goals. Once you’re in a state of ketosis, you can transition to a more flexible ketogenic plan. You can rotate complex carbs, like sweet potatoes, pumpkin, and butternut squash, into the diet every three to four days to maintain your glycogen stores if you work out and lift weights regularly.


Familial hypercholesterolemia is a condition where one or more of the genes for the LDL receptor are defective. Having the right amount of properly functioning LDL receptors plays a vital role in maintaining healthy cholesterol levels by clearing LDL cholesterol out of the blood. Without an adequate amount of LDL receptors, the blood is much more likely to accumulate high levels of LDL particles, increasing the body’s vulnerability to cardiovascular disease significantly. [28]
We admit approximately four children ranging from infants to adolescents each month to participate in the therapeutic ketogenic diet program. New patients take part in a 3-day orientation (Monday through Wednesday) that starts the child on the diet and provides education for the family. After that, we follow up with the patients in our clinic every one to three months.
Epilepsy is a disorder where recurrent seizures (fits) are caused by abnormal electrical discharges from the brain. In most people seizures can be controlled by one or more antiepileptic medicines, but seizures may not be helped by these medicines after a while (called drug‐resistant epilepsy). For people who have drug‐resistant epilepsy, a special diet (called a ketogenic diet) may be considered. Ketogenic diets are high in fat and low in carbohydrate.
In conclusion, all the mechanisms described above lead to systemic modifications and a dynamic metabolic homeostasis, in which the interplay among KB, glucose levels, mitochondrial function, synaptic neurotransmitters, and channel modifications can lead to changes in the seizure threshold and hyperexcitability. These changes contribute to the final antiseizure mechanism of KD.
The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture, and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more food energy than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein, and carbohydrate is then evenly divided across the meals.[37]
The classic ketogenic diet used as far back as the 1920s is a four to one ratio (in grams) of fat to carbohydrates plus protein. That’s about 90 percent of calories coming from fat. We typically teach our patients a modified Atkins diet, which limits the net carbohydrate intake to 20 grams per day without any limitations on the amount of protein and fat they eat. Typically, about 60 to 70 percent of their daily calorie intake comes from fat. (That’s more than double what the USDA Dietary Guidelines recommend.)
There were some commonalities among the diets, of course; all these traditional people ate some animal products, and all consumed a fair amount of fat, whether from plant or animal sources. All the food was, of course, locally grown, locally harvested, or locally hunted, since these isolated groups lacked access to the industrialized food of modern “civilization.”

But no fear, there’s always a new miracle around the corner, and in 1998 the newspaper reporters and TV newscasters, having effortlessly drifted away from interferon and interleukin-2 and the bone marrow transplant craze, were all in a tizzy over the newest “final” solution to cancer, anti-angiogenesis, based on the pioneering work of the late Dr. Judah Folkman of Harvard. Dr. Folkman had spent decades studying the process of angiogenesis in cancer tissues, the formation of new blood vessels that allow tumors to grow quickly and invade through normal tissues and organs with deadly effect.
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.
During a seizure, networks of neurons fire when they are not supposed to. This can happen because the brain cells are more excitable and are releasing lots of excitatory neurotransmitters, like glutamate. Or it could be that neighboring brain cells aren’t able to suppress the spread of excitability like they normally would using inhibitory neurotransmitters like gamma-aminobutyric acid, or GABA.
Eliminating all sugars and simple carbohydrates and severely restricting other carbohydrates results in a condition called ketosis, in which the body burns stored fat instead of glucose for fuel. It is not clear why ketosis inhibits seizures, but in an earlier Johns Hopkins study involving 150 children with difficult-to-control epilepsy, more than half had a 50% or greater reduction in seizures and one-fourth experienced a 90% improvement.
The ketogenic diet may have a role in treating disorders of cellular proliferation, especially cancer. Just as chemotherapy selectively targets tumors based on differences in the way they divide compared with normal cells, investigators have proposed targeting tumors on the basis of differences in their metabolism. Normal tissue can adapt readily to using ketones (instead of glucose) as a substrate, but malignant cells probably do not have the same degree of metabolic flexibility [23]. One case report in 1995 [24, Class III] described the use of the ketogenic diet in two girls with advanced astrocytomas, based on the idea that brain tumors are less able than healthy brain tissue to use ketones as an energy source. In this report, PET studies demonstrated a 20% reduction in glucose uptake by the tumors following the initiation of the ketogenic diet. One of the patients actually showed improvement during the course of the study and has continued to be well, without evidence of tumor progression (T. Seyfried, personal communication, 2008).
May this letter find you and your loved ones happy and healthy for without you I would not be in such an improved state of physical health? It is not often I get to put pencil to paper for not only could I not concentrate due to opiate pharmaceuticals (couldn't express oneself due to lack of cognitive thinking) but the pain, inability to get comfortable due to lymphodemia and anxiety from stress (from lack of cash flow for food, bills, medicines plus the high expense of bandages & ointments) have prevented me from making contact but ....still after this prolonged period of time, I feel it necessary to write personally to mention just how dramatically you changed the world my two children and I live in. My sister Casey Lee Smith, arrived 6 months ago from the USA to run my household and it is through "Phoenix Tears" website she was able to make contact with you and learn all about the many wondrous benefits of medicinal Cannabis oil. When the treatment arrived, I was overwhelmed for I am a single Mother and your generosity brought tears to my eyes (even now it is hard to fight tears as I write) It has been rough to say the least. Feeling helpless, overly tired and frustrated by the lack of qualified physicians in my local town. I became depressed. My ex-husband felt he should prepare the kids for my untimely death. The location of my cancer spread throughout my left quadrant into my lymph and into the brain. I became bed ridden and lost hope. I will lose my house shortly but now i know it won't be my life. So, "THANK YOU" for the gracious gift and know you are loved! Sending love to you forever and always.
The keto diet works for such a high percentage of people because it targets several key, underlying causes of weight gain — including hormonal imbalances, especially insulin resistance coupled with high blood sugar levels, and the cycle of restricting and “binging” on empty calories due to hunger that so many dieters struggle with. In fact, these are some of the direct benefits of the keto diet.

Leanne: Yeah totally, chill out. Do a little meditation if you need to get into the zone. Exactly. You mentioned vegetable oils causing inflammation, are there specific fats that will help us, like we’ve talked a little bit about saturated fats, we all know trans fats don’t even go there … the mono poly saturated, unsaturated, is there a certain ratio that we should be aiming for. I know you’re the guy that will just slice off butter and eat it … I am too, a little bit of Himalayan rock salt on there never hurt anyone. Are there specific facts that we should be focusing on?
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