• Standard ketogenic diet (SKD) — SKD is the type I typically recommend for most people, because it is very effective. It focuses on high consumption of healthy fats: As I explain in my book, "Fat for Fuel," you should aim for having 70 to 85 percent of your total daily calories to come from healthy fats. For your protein intake, the general rule of thumb is to follow the formula of 1 gram of protein for every kilogram of your lean body mass.
After discharge, caregivers are instructed to check urine ketones daily; if necessary,  the diet is individually adjusted after consultation by telephone or email to maximize seizure control. Weight is monitored by the parents and reported if significantly changed. Periodic laboratory measures are obtained every 3 months in order to monitor for side-effects (for example – lipid profile, electrolytes, anticonvulsant levels, urine calcium/creatinine). The use of a medication called Cytra-K led to a large reduction in kidney stones when provided to all children at one hospital starting the ketogenic diet. Some child neurologists recommend its use for all children on the classic ketogenic diet.
“But if you’re a young and healthy adult, I have no safety concerns about removing carbs,” he adds. “It’s really not a radical concept.” You may experience some short-term issues like bad breath, constipation and flu-like symptoms. (Drinking lots of water can help.) But the lasting benefits could range from reduced hunger and increased energy to weight loss. Some preliminary research even hints at memory improvements.

The theory of ketogenic diets for cancer does not rest on depriving the tumor of glucose since, as you say, blood glucose is regulated (not from fat, though — except for a small amount from glycerol and other minor exceptions, you can’t make glucose from fat). In addition many tumors will overexpress the glucose receptors. The logic rests with regulating insulin and providing alternative fuel as ketone bodies. Remember, glucose — really most nutrients — have control effects as well being fuels. So the goal is to repress the utilization of glucose by inhibition with derivatives of fat and ketone bodies (acetyl-CoA, for example).

Keto flu symptoms and side effects can include feeling tired, having difficulty sleeping, digestive issues like constipation, weakness during workouts, being moody, losing libido and having bad breath. Fortunately, these side effects don’t affect everyone and often only last for 1–2 weeks. (And yes, you CAN build muscle on keto.) Overall, symptoms go away as your body adjusts to being in ketosis.

Sharon M. Nickols-Richardson, PhD, RD, , Mary Dean Coleman, PhD, RD, Joanne J. Volpe, Kathy W. Hosig, PhD, MPH, RD, “Perceived Hunger Is Lower and Weight Loss Is Greater in Overweight Premenopausal Women Consuming a Low-Carbohydrate/High-Protein vs High-Carbohydrate/Low-Fat Diet,” The Journal of Pediatrics: Vol 105, Issue 9: 1433–1437; September 2005. http://www.sciencedirect.com/science/article/pii/S000282230501151X.

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.


I had the same doubt about coconut oil, I read someone recommending that the first thing to do would be dropping bulletproof coffee and changing to olive oil. Do you think is that valid? My father also has high cholesterol and had a heart attack, though he also had a smoking/drinking record. I never drink/smoke and always exercise, so I hope that compensates, since all the other markers seem to be normal..,though I'm worried and thought if I should just eat more fiber and come back to a Paleo diet including some fruit ( the same guy that recommended the olive oil instead of coconut said that, I don't know if it's valid)

The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains, and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]


In the mid-1990s, Hollywood producer Jim Abrahams, whose son's severe epilepsy was effectively controlled by the diet, created the Charlie Foundation to promote it. Publicity included an appearance on NBC's Dateline programme and ...First Do No Harm (1997), a made-for-television film starring Meryl Streep. The foundation sponsored a multicentre research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet.[1]
It’s also interesting that the cancers used to produce the basic science cited by Dr. Seyfried are virtually all brain cancers and that virtually all the evidence comes from rodent tumor models. For one thing, if there is a tumor type that exhibits the Warburg effect and a high degree of metabolic derangement, it’s brain tumors. It’s no coincidence that dichloroacetate was first tested in brain tumors. In this study, VM/Dk mice were used, and a mouse histiocytoma cell line resembling human glioblastoma multiforme with macrophage/microglial properties derived from that same mouse strain (VM-M3) was implanted subcutaneously. This cell line has the property of metastasizing quickly and widely when implanted under the skin and allowed to grow, which actually makes it not very much like brain tumors, which seldom metastasize and usually kill through local invasion and taking up increasing volume in the closed space of the skull, something the brain most definitely does not like. The results showed that a ketogenic diet increased mean survival time by over 56%, while a combination of a ketogenic diet and hyperbaric oxygen therapy (HBOT) increased survival time 78%. The result is interesting, but it is a mouse tumor model, not a human tumor model, and that makes its applicability to humans tenuous, particularly given the nature of the murine tumor, but probably worth investigating further.

The diet can be started as an outpatient and many physician and dietician team centers do this successfully. However, it is important to ensure close proximity of the child to the medical team during the initiation period in case of difficulties. The intense educational process afforded by inpatient initiation may be preferable for some families and ketogenic diet centers. Also, it allows the families time to review the overall medical treatment, spend additional time with their treating neurologist familiarizing him/her with the epilepsy, and also to meet other families starting the diet at the same time (if admissions are done in a group). Most importantly, inpatient initiation allows observation of the child during this big change in metabolism.

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 ketone bodies are possibly anticonvulsant; in animal models, acetoacetate and acetone protect against seizures. The ketogenic diet results in adaptive changes to brain energy metabolism that increase the energy reserves; ketone bodies are a more efficient fuel than glucose, and the number of mitochondria is increased. This may help the neurons to remain stable in the face of increased energy demand during a seizure, and may confer a neuroprotective effect.[56]
Purpose of review Altered glucose metabolism in cancer cells is an almost ubiquitous observation, yet hardly exploited therapeutically. However, ketogenic diets have gained growing attention in recent years as a nontoxic broad-spectrum approach to target this major metabolic difference between normal and cancer cells. Although much research still needs to be done, new knowledge has been gained about the optimal utilization of ketogenic diets for cancer treatment that this review aims to summarize.

To determine whether you’re in ketosis and what degree of ketosis you’re in, test your ketones each morning. Blood ketone testing is the most accurate method—I do not recommend breath or urine ketone monitoring. In our practice, we recommend the Precision Xtra Blood Glucose Meter Kit, which can be purchased on Amazon (you can buy test strips for this meter in bulk on eBay for a lower cost). Keto Mojo is another good meter with affordable test strips.
Bulk buy and cook. If you’re someone who doesn’t like to spend a lot of time in the kitchen, this is the best of both worlds. Buying your food at bulk (specifically from wholesalers) can reduce the cost per pound tremendously. Plus, you can make ahead food (bulk cook chicken thighs for pre-made meat, or cook entire meals) that are used as leftovers, so you spend less time cooking.
More research is needed to determine whether the kind of extreme carb restriction associated with keto diets is necessary to unlock all these benefits, especially if you’re healthy. “Ketogenic and other very-low-carbohydrate diets can be quite challenging to follow over the long term, and the possibility of adverse effects has not been ruled out,” says Dr. David Ludwig, a professor of nutrition at Harvard School of Public Health. “Usually, such severe restriction isn’t necessary.” He points out that not all carbs are equal, and that the speed with which a carbohydrate food affects your blood sugar—what’s known as its glycemic index—makes a difference.
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.
Adhering to a keto diet can be challenging and may be particularly so for cancer patients, many of whom may be enduring side effects from treatment. Entering a state of ketosis requires following a strict diet-plan, comprised of high fat foods such as bacon, heavy cream, and butter, while simultaneously restricting other categories of food, such as starchy vegetables like sweet potatoes, whole grains, and certain fruits. This dramatic change in eating habits can lead to nausea and digestive upset in addition to unintentional weight loss and increased risk of malnutrition.
The bottom line here is that the ketogenic diet is a powerful metabolic tool for treating a wide range of illnesses. It is not a fad diet, and if it is implemented correctly, it corrects metabolic function at the cellular level.  This website discusses in detail the mechanisms of a ketogenic diet, including side effects, benefits and other information.
Several laboratory abnormalities have been reported in children on the ketogenic diet, although none has been found to have clinical significance. Patients on the ketogenic diet are in a chronic acidotic state, putting them at risk for osteopenia. Some studies have shown a progressive loss of bone mineral content, resulting in osteopenia and osteoporosis; this loss occurred with ketogenic diet treatment despite improved serum vitamin D concentrations.

I too am a lean mass hyper responder and have FH with very high levels of LDL and HDL but have never had the tests to separate out the different types of LDL. I thought my relatively low fat diet with high fibre would be good for me and help prevent plaque build up, although I have read some excellent articles and books relating to the link between high cholesterol and heart disease being very fabricated. When I recently had a well-man check up and discovered that I was pre type II diabetic, I thought, WTF! I have been so careful for so many years not to have simple sugars in my diet and only complex carbs with plenty of fibre - and yet, there I am with my Dr telling me I'm on the verge of diabetes! So, I'm going on the side of plenty of good fats are really good for me - even with really high cholesterol levels - and am now two weeks into a Keto diet - lost a bit of weight, so boy am I skinny now - but feeling great with much more energy and clarity of thought / consciousness. My gout is subsiding, my eczema is not flaring up so much and not so itchy in other areas either! Also the keto diet feels and tastes so good - I love eating fish and meat and avocados and love to simply eat teaspoons of coconut oil. I tend to snack on nuts and seeds during the day after a morning fast so I only eat between midday and about 6-7pm in the evening. Who knows whether or not I will have a heart attack in my late fifties like my mum or a stroke at 65 like my father!


Ketosis: What is ketosis? Ketosis is a metabolic process, and it involves the body burning stored fat instead of glucose. Some people try to induce this with a low-carb diet, which can be healthy. However, ketosis also produces acid, and high levels of this can cause severe complications, especially for people with diabetes. Learn more here. Read now
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”]
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.
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?

Adhering to a keto diet can be challenging and may be particularly so for cancer patients, many of whom may be enduring side effects from treatment. Entering a state of ketosis requires following a strict diet-plan, comprised of high fat foods such as bacon, heavy cream, and butter, while simultaneously restricting other categories of food, such as starchy vegetables like sweet potatoes, whole grains, and certain fruits. This dramatic change in eating habits can lead to nausea and digestive upset in addition to unintentional weight loss and increased risk of malnutrition.
After scouring the literature, he became quite attracted to the “good science” behind the ketogenic hypothesis, so under Dr. Seyfried’s direct supervision, he began the diet. Though the patient seems quite enthusiastic about his response, he admits in his note that with the diet there has been “no progression,” presumably in terms of x-ray studies, and some improvement in the blood studies. He still considers his disease as “incurable.”
Your current cholesterol levels l is higher than I would personally feel comfortable with. I would consider making a few dietary changes (i.e., increasing fiber and net carbs, reducing saturated fat, and increasing protein), especially given your lack of improved cognition and decreased ability to work out. I wish you the best of luck going forward. - Franziska
On the ketogenic diet, carbohydrates are restricted and so cannot provide for all the metabolic needs of the body. Instead, fatty acids are used as the major source of fuel. These are used through fatty-acid oxidation in the cell's mitochondria (the energy-producing parts of the cell). Humans can convert some amino acids into glucose by a process called gluconeogenesis, but cannot do this by using fatty acids.[57] Since amino acids are needed to make proteins, which are essential for growth and repair of body tissues, these cannot be used only to produce glucose. This could pose a problem for the brain, since it is normally fuelled solely by glucose, and most fatty acids do not cross the blood–brain barrier. However, the liver can use long-chain fatty acids to synthesise the three ketone bodies β-hydroxybutyrate, acetoacetate and acetone. These ketone bodies enter the brain and partially substitute for blood glucose as a source of energy.[56]
Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >
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