To avoid the overload of stress, I find my relief by being the person at the origin of my son’s quality of life. I am not a doctor, a pharmacist, or a research person. I am just Max’s mother. For almost 15 years I have been using food to treat the adverse side effects of his syndrome. Angelman Syndrome (AS) is one of many neurological disorders that can be treated with therapeutic diets.
The New York Times pieces also points out that studies are disproving this concern and making a case for both children and adults with type 1 diabetes to consider a ketogenic diet. Specifically, a 2018 study published in the journal, Pediatrics, which took a look at glycemic control among children and adults with type 1 diabetes who followed a very low-carbohydrate, high-protein diet. The researchers found that both the adults and children who consumed this diet along with smaller doses of insulin than typically required exhibited “exceptional” blood sugar control without high rates of complications. In addition, the study data did not show an adverse effect of a very low-carbohydrate diet on children’s growth, although more research may still be a good idea, according to researchers.
Sleep improvements are a bit more of a mystery. Studies have shown that ketogenic dieting improves sleep by decreasing REM and increasing slow-wave sleep patterns. While the exact mechanism is unclear, it likely is related to the complex biochemical shifts involving the brain’s use of ketones for energy combined with other body tissues directly burning fat.
While these findings are preliminary, in one study of mice, the keto diet helped reduce anxiety. The research suggests this could be due to the protective brain benefits of intake of healthy fats and low levels of sugar. A follow-up study found that mice exposed to a ketogenic diet while in utero showed less susceptibility to anxiety and depression than mice born to mothers who were not on the keto diet. Here’s what it’s really like to follow the keto diet.
It’s only dangerous to not get enough carbs at each meal if one is taking too much meds or insulin for the amount of carbs they are eating! Restricting carbohydrates doesn’t lead to hypoglycemia unawareness, but having lots of lows and lots of highs will (and decreasing insulin and carbs leads to way fewer highs and fewer lows, or at least it can). On the other hand, being in ketosis does make low blood sugars less negative as an experience. I still feel my lows just fine, but they are less of an emergency because my brain still works (feeding on ketones) and by body doesn’t freak out and release tons of adrenaline that then makes me want to eat a house. Mind you, I still wake up and know immediately if I’m low, I know from experience and how it feels in my head and body but without the crazy shakes. This is not unawareness but it is less reactive.
The ketogenic diet may seem like the latest weight-loss craze, but it’s actually been around for nearly a century. Developed in the 1920s, this ultra-low-carb, high-fat eating plan was originally used to treat seizures in people with epilepsy. Today, it’s getting some serious attention for an entirely different reason. “There’s growing research showing that the ketogenic diet is effective for managing blood sugar in people with diabetes,” says William Yancy, MD, program director at the Duke Diet and Fitness Center in Durham, North Carolina. “However, because we don’t have studies [lasting] longer than two or three years, we don’t know what can happen with regard to complications over longer periods of time.”

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Everyone has emerging cancer cells, but the cells can only develop into full-blown cancers if the body fails to kill off them off. DNA damage, inflammation, poor cellular cleanup, high blood sugar, and inability of the immune system to kill emerging cancer cells together lead to cancers. Proponents claim that ketogenic diets may help prevent cancers by addressing all of these aspects.
Thank you for your wonderful comments Marcia. To share more about me personally with you all…I am not a completely non-diabetic Certified Diabetes Educator. I found out I had Prediabetes 15 years ago when I became a Diabetes Educator. I tested my own A1c and found it was 5.8%. The incredible news? There have been years when my A1c dropped to a normal level of 5.4%…out of the prediabetes range. My last A1c in May was 5.8%, so I still have Prediabetes 15 years later, but not diabetes, and without any medication, just the sensible diet I’ve discussed and exercise, so I really am living with this. I feel it everyday, I wonder what my A1c is going to be just like you every 6 months when I go to have it drawn.
Earlier in this article, I briefly mentioned how consuming too much sugar can impair brain function and cause plaque build up in the brain. Many studies on Alzheimer’s disease patients agree with the biochemistry as well. In fact, A group of scientists reviewed the literature and concluded that “high carbohydrate intake worsens cognitive performance and behavior in patients with Alzheimer’s disease.” This means that eating more carbohydrates cause more problems in the brain. Will the opposite (eating fewer carbs) improve brain function?
When the body's glycogen stores begin to get depleted, rates of beta-oxidation increase, resulting in the mobilization of free fatty acids from fat tissue. This is where the metabolic state of ketosis comes in. During beta-oxidation, ketone bodies are released from the liver—because they cannot be utilized by the liver—and travel to the brain to be used for fuel. The free fatty acids can then be turned into a usable energy substrate.
According to Dr. Cabeca, “Fasting is a key aspect of a healthy diet and has many anti-aging effects.” In particular Dr. Cabeca recommends fasting to women during or after menopause due to it’s anti-aging effects. For example, a 2016 study published in the Journal of the American Medical Association found that when women went 12.5 hours between dinner and breakfast (a common form of fasting), the overnight fast seemed to help improve immune system functioning to the point that it reduced their risk for breast cancer. (03) 
I’ve been eating LCHF for almost a year. I’ve lost 40 lbs, feel hungry less often, reversed my insulin resistance, have lots more energy but my cholesterol keeps jumping up, not just creeping, but taking huge leaps! It’s in the mid 300’s now and my Dr wants me to go on statin drugs of which I’m very resistant, I don’t feel comfortable taking drugs. I read so often how this diet lowers cholesterol, not me! Any clue as to “why me?”
The end result of the “ketone diet” is staying fueled off of circulating high ketones (which are also sometimes called ketone bodies) — which is what’s responsible for altering your metabolism in a way that some people like to say turns you into a “fat-burning machine.” Both in terms of how it feels physically and mentally, along with the impact it has on the body, being in ketosis is very different than a “glycolytic state,” where blood glucose (sugar) serves as the body’s energy source.
To lower your heart risks while following a keto diet, be mindful of the types of fats you’re eating. “Most nutritionists encourage people to get their fat from heart-healthy mono- and polyunsaturated fats,” Urbanski says. So even though going keto may sound like a license to load up on bacon and butter, reach for unsaturated fats from foods such as olives, nuts, seeds, and avocados, and olive, canola, and nut oils.
Most people already know about the keto flu, which can happen when you start the diet. It’s a result of the body adapting to the low-carb state. Lowering carb intake forces the body to burn ketones for energy instead of glucose. Once the body is in ketosis — burning fat instead of glucose — the keto diet is working. But you may not feel so great at first, hence the term keto flu.
Fat (and the ketones produced from fat) are a readily available source of fuel. Once someone is fat adapted and in ketosis, they will find they can easily go hours (even days) without food and not have drastic energy level swings. And if someone is looking for a non caffeine, non-sugar 'pick me up' while in a ketogenic state, then supplemental ketone salts are the perfect answer.
This suggests that we should cycle in and out of ketosis by periodically increasing carbs to avoid this hypothyroidism. Incidentally, the more I read of the much-maligned Bob Atkins’ writings the more impressed I become. He clearly was extremely well-read in the scientific literature and modified and expanded his protocols as he got more information. If you read his Age-Defying Diet book, apart from Dr D’s absolute prohibition of grains, it isn’t too different from WB principles. See this quote (page 290)
Across the globe, diets high in vegetables and fruit are linked to reducing long-term chronic disease risk, including diabetes, heart disease, and lifestyle-related cancers. Data suggests that the more produce we eat, the better off we are. On keto, however, you have to restrict how many net carbs (and therefore, veggies) you’re consuming per day, minimizing their beneficial effects.
This article is a perfect example of the misinformation regarding diabetes and insulin resistance. The authors stance against the ketogenic diet is a simple, “its just too hard, I cant live without fruit.” She projects her lack of willpower to her audience. Ketogenic diets are a great way to reduce insulin levels and get to the root of the problem.
Abbey, I appreciate all the work you put into this but there are a few things you missed. Not all oils are keto friendly. Vegetable oils are a huge no-no which was not mentioned. Regular mayo usually contains soybean oil which should be avoided. You also missed that foods with preservatives are a no-no which excludes some cheeses (you said enjoy all the cheese you like). Processed sliced cheese or pre-shredded cheese in a bag at the grocery store contains preservatives. Ever notice how shredded cheese in a bag never sticks to itself but when you shred your own cheese it sticks? Preservatives. Most nuts are okay but peanuts are a legume and should be consumed in very small amounts or avoided altogether. Don’t go crazy either, nuts do have carbs. I don’t eat more than a half cup a day of salted almonds. That said, you could have mentioned that getting salted nuts is ideal as you do excrete more salt and other minerals in your urine (eating keto is diuretic so attention must be paid to salt, potassium, magnesium, etc. as you did mention) so finding simple ways to add salt and other minerals is helpful. I also take a multi-vitamin daily. You mentioned you cannot do high intensity workouts. You are not supposed to do high intensity workouts as elevating your heart rate too high actually stops the fat burning process in your body. Your heart rate should be 180 beats minus your age +/- 5 beats depending on fitness level. A 40 year old obese person shouldn’t go over 135 beats/min during a workout as that is the optimal fat burning window. Higher than that and your body reverts to storing fat reserves thinking it will run out if it keeps this pace. Which bring me to metabolism. Its been long believed a high metabolism is good. A high metabolism leads to more hunger (because you’re burning glucose faster), ingesting more food, and typically gaining more weight. Slowing your metabolism down AND teaching your body to consume slow burning ketones instead of quick burning glucose puts less stress on your liver mainly and on your body in general. There’s a lot more but this is getting long so I’ll finish with this. You said this diet focuses on quantity of food and not quality. This is confusing to me….wouldn’t organic and grass-fed meats, be of better quality than non-organic and grain fed meat? (they feed animals grains to fatten them up….shouldn’t that be a huge warning sign for us?). Is food without preservatives not better quality than food with preservatives? Aren’t beverages with no sugar or artificial sweeteners of better quality than sugar/artificial sweetener-filled beverages? I’ve never seen any keto advocate advise ignoring quality foods, in fact its quite the opposite.
To see where you stand on the ketosis scale, you can test your ketone levels with a blood meter or with urine strips, the latter of which works similar to a pregnancy test and generally costs less than a dime a piece. Recent research shared in The American Journal of Clinical Nutrition, however, found that breath monitors (typically $200 to $300) provide the most accurate readings. Dozens of meters of all three formats are currently available on Amazon.
The whole area of calcium supplementation is rife with misinformation. Mainstream docs assume that osteoporosis is due solely to lack of calcium, ignoring that you need to have adequate Vit D levels to absorb the calcium in the first place (and their idea of adequate D blood levels are absurdly low) as well as Vit K2. Since bone is made of calcium phosphate, you also need adequate phosphate as well. Milk contains calcium phosphate – no surprise since it is designed to build the bones of the growing animal – so dairy is your best source of calcium. You also need protein since bone is calcium phosphate within a protein matrix. To rebuild osteoporotic bone you need 1.2gm/Kg of body weight, 50% more than the RDA of 0.8gm/Kg.
The ketogenic state in particular can increase the hormones that make you feel full and decrease the hormones that make you feel hungry. Sounds great, right? Well, once you’re off the keto diet, the appetite-suppressing hormones will increase significantly from your baseline. Meaning that you’ll likely feel even hungrier than you did before you started!
The studies done on ketosis and endurance sports performance paint a pretty clear picture – it helps.  One of the most detailed studies on fat utilisation and performance (compared to a standard carb diet) was named the FASTER study - the results found that those who were on a ketogenic type diet had more mitochondria than the control group, lower oxidative stress, lower lactate load and that the fat adapted and fuelled athletes could function off fat for a much higher intensity than the non-fat adapted counter parts.
Fresh fruits supply only a small fraction of the fructose Americans consume (the biggest source is sugary beverages). Sugar in fruit is accompanied by healthful nutrients and antioxidants, as well as fiber, which slows absorption of fructose so it’s highly unlikely that the fructose in even very sweet fruit could have any undesirable health effects.

Look for natural sources of electrolytes or take an over-the-counter supplement. “Avocados, leafy greens, asparagus, and cruciferous veggies are great for providing important electrolytes, says Josh Axe, DNM, DC, CNS, a certified doctor of natural medicine and clinical nutritionist. Dr. Axe also suggests a magnesium supplement to help you sleep and avoid cramps or constipation.


7. I should mention ALL my health markers have DRASTICALLY improved including cholesterol and inflammation markers? My fatty liver is resolving and my cardio markers are perfect! The study where you cited there were not significant changed in diabetes markers in two months, well it takes longer! Check it out at 6 and 8 months. Most people will show a VERY different story than what you are reporting!

When the ketogenic diet is followed in a healthy manner (which considers avocados a healthy fat instead of pork rinds), there is some evidence that the diet can improve heart health by reducing cholesterol. One study found that HDL ("good") cholesterol levels significantly increased in those following the keto diet. The LDL ("bad") cholesterol went down significantly.
The ketogenic diet typically reduces carbohydrate intake to less than 50 grams per day — and calls for increased protein and fat intake, according to a review published in August 2013 in the European Journal of Clinical Nutrition. Roughly speaking, on keto you’ll get 70 to 80 percent of your calories from fat, about 20 percent from protein, and as little as 5 percent from carbs.
If not treated or reversed, dehydration can lead to acute kidney injury, Dr. Rahnama says. That’s not the only way the keto diet can put your kidneys at risk, however. “Kidney stones or damage to the kidney may also be a side effect,” Grace Derocha, RD, a certified diabetes educator and certified health coach at Blue Cross Blue Shield of Michigan says. High levels of nitrogen created by excess protein can also increase pressure in your kidneys. This can lead to the formation of more stones and damage your kidney cells.

If you’re wondering why iron is at risk on a meat-based diet, hear me out. Many grain foods provide a considerable amount of iron, because wholegrains naturally contain iron in their inner layer called the ‘germ’. Another reason is that some grain products can have iron added to them during manufacturing. So, once you cut grains out, your iron status could suffer, which can lead to unpleasant symptoms like tiredness and lethargy. It can even compromise your immune system.
A: The most common ways to track your carbs is through MyFitnessPal and their mobile app. You cannot track net carbs on the app, although you can track your total carb intake and your total fiber intake. To get your net carbs, just subtract your total fiber intake from your total carb intake. I have written an article on How to Track Carbs on MyFitnessPal.
Increases in cholesterol levels need discussion too. We do see temporary increases in cholesterol levels often as individuals transition onto a ketogenic diet. However, when you examine lipid particle size (a more important way to look at the cardiovascular risks), the risk pattern doesn’t seem to increase with a ketogenic diet. Harvard Health has written about lipid particle size here before: http://www.health.harvard.edu/womens-health/should-you-seek-advanced-cholesterol-testing-
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.
The ketogenic (or keto) diet was initially designed to treat severe epilepsy in infants and children. As an intervention diet, it was intended to be administered for short periods of time under the supervision of a medical team. Now popular for it’s rapid weight-loss side effects, the diet has moved to the mainstream public as an alternative low-carb diet.
This concept was previously unthinkable as modern nutritional science was led to believe that the body’s metabolism relied on gluconeogenesis to create ATP as energy for the body’s metabolic processes. Glycogen derives from dietary carbohydrate intake, so by removing it from the diet, nutritionists expected devastating health results to emerge in practitioners of the diet.
You can absolutely be in ketosis and eat 50g of net carbs a day. Maybe not everyone, but many people can maintain ketosis at that level of carb if fat/protein intake is OK. I have experienced this myself, and tested with blood keto meter. It would be interesting to test people who have been on the WB diet to see how me many are also in ketosis. I would bet a significant portion cycles into ketosis very regularly, and some are ketotic most of the time.

When carbohydrate consumption is limited, your body has to use an alternate fuel source to keep your brain going. This is the general premise behind the ketogenic diet. “The ketogenic diet is a high fat diet with low carbohydrate and moderate protein content,” says Gabrielle Mancella, a Registered Dietitian with Orlando Health. “Carbohydrate is depleted to provide an alternative fuel source, known as ketones, to the brain. The body converts from burning carbohydrates to burning fats, known as ketosis.”
After 32 weeks, those in the keto diet group lowered their HbA1c more than those in the plate group with more than 50% achieving a reduction to less than 6.5%, basically reversing their diabetes. None in the plate group did this well. As for weight loss, those in the keto low-carb group lost on average of 28 pounds, while those in the plate group lost an average of 6.6 pounds.1
In general, men tend to do better on a long term ketogenic diet than women do. From my own research and experimentation, women can follow a keto diet, but with some adaptions. Most women will do well with a cyclical ketogenic diet when they stay on ketogenic diet most of the time and eat starchy carbohydrates occasionally to spike calories and carbs.
Cyclical ketogenic diet (CKD): If you find it difficult to stick to a very low-carb diet every day, especially for months on end, you might want to consider a carb-cycling diet instead. Carb cycling increases carbohydrate intake (and sometimes calories in general) only at the right time and in the right amounts, usually about 1–2 times per week (such as on weekends).
I believe that nature teaches us in wonderful ways about what works. Take the four seasons for example. I’ve adapted a ketogenic way of eating that is a cyclic method. I workout a lot, and a focus of mine is increasing muscle mass and strength. While I wouldn’t be able to maintain and/or increase those two factors with the amount of intense workouts I have, I don’t follow a strict ketogenic “diet”. I go about 3 weeks of being in keto, and then for a couple of days, I eat whatever I want. That means, I can eat cake, cookies, pies, whatever I want, for those two days. I even get to enjoy birthday cake ;). Then after that, I go back to keto. It’s work WONDERS. It’s EXTREMELY maintainable, I’m still loosing weight and achieving my goals. I’ve also been getting better at listening to my body and understanding how certain foods affect my body—which is something we’re not taught. It’s really amazing how we have such intelligent systems that are ALWAYS communicating with us. We just have to understand how to listen to them. Truly. The problem with a lot of our society, is that we are stuck in the high-end of the cyclic, or the feasting mode, and we think it’s normal! Hence the many ailments and medical conditions that keep increasing. The point is, there are many variations of following a ketogenic way of eating, and it DOES require a life-style change. Just like any other recommendation from a dietician or educator.
Obesity has become a serious chronic disease in both developing and developed countries. Furthermore, it is associated with a variety of chronic diseases (1–4). It is estimated that in the United States alone approximately 300,000 people die each year from obesity-related diseases (5,6). Different methods for reducing weight using reduced calorie and fat intake combined with exercise have failed to show sustained long-term effects (7–9). Recent studies from various laboratories (10,11), including our own (12), have shown that a high fat diet rich in polyunsaturated fatty acids (ketogenic diet) is quite effective in reducing body weight and the risk factors for various chronic diseases. The ketogenic diet was originally introduced in 1920 (13). In this diet, the fat to carbohydrate ratio is 5:1. While there was a significant decrease in the weight of obese patients who were on a ketogenic diet (12), the reverse occurred when the diet changed to one high in carbohydrates (14).
"On a ketogenic diet, your intake of fruits and vegetables is extremely limited, and we all know how important the fiber, vitamins, minerals, and other compounds in fruits and veggies are," says Libby Parker, R.D., a dietitian who specializes in treatment and prevention of eating disorders. It's true: There are a lot of healthy but high-carb foods you can't eat on the ketogenic diet. That's one of the reasons keto is usually pretty low in fiber, which isn't so great long-term. "Fiber is not only protective against many gastrointestinal cancers, it is also a big factor in fullness and weight loss," Parker explains. "Furthermore, constipation is very common on low-fiber diets like the keto diet." (That said, These Healthy, High-Fat Foods Can Help You Feel Full Longer.)
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