I would just like to share with you that my patients are HORRIFIED if their physicians ask them to cut out “everything white” in their diet. This is what some doctors ask for…essentially asking for the Ketogenic diet and most of my patients are in shock! Not only would I never want to skip a year of my birthday cake, but I wouldn’t ask my patients to either! One slice of cake is certainly not going to harm anyone with diabetes and hopefully you know enough about carbohydrates and their short term effect on BG levels to know this too! I am not a Registered Dietitian, so I couldn’t speak to this diet in regard to children with epilepsy. Are you a Neuro RN? TheDiabetesCouncil did just post another article where 25 Registered Dieticians weighed in regarding the Ketogenic Diet, so I would encourage you all to check that out!
If you’re science oriented, you can also try his 2008 book “Good Calories, Bad Calories”. For a more journalistic view on the events that led to fat phobia starting in the 1950’s (as well as the joke that is the Mediterranean Diet), there is also Nina Teicholz’s 2014 book “The Big Fat Surprise.” Be sure to check out youtube for some of these folks’ lectures and discussions. They are not advocating whacky stuff.
Casual chronic keto is at some risk of those same side effects. Sure, there are sporadic anecdotal cases where there appears (so far) to be no harm, but these are not large population RCTs. The KD-in-epilepsy data is closer to being RCT data. There being no ancestral case for chronic keto, we need to learn what we can from the formal studies (and sure, endeavor to separate the ailment, med and diet effects).
Diet Doctor has a number of videos and posts about positive impacts of the ketogenic diet for migraines, brain cancer, and traumatic brain injury. Recently, two psychiatrists reviewed the research base for psychiatric issues and noted that while promising, it is slim. Dr. Ede takes a more hopeful view. “My mantra is that the most powerful way to change your brain chemistry is by food, because that’s where brain chemicals come from in the first place,” she says.
At some point, the pancreas is literally burned out and can’t produce enough insulin to keep even basic blood sugar under control, let alone after a high-carb meal. This state is end-stage of type 2 diabetes where insulin injections become necessary [7]. Type 2 diabetics do not produce less insulin than normal, but the insulin resistance increases the need for insulin. A diabetic pancreas is eventually unable to supply this increased demand.
Ketosis is different, because, when in the state of ketosis, the brain will prefer ketones over glucose. For the dieter this is good! The body will not have to break down protein for energy. In turn the body will be forced to use its fat reserves, a.k.a. your love handles, for its energy. This is why a low-carb diet is such a good method of dieting.
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.”
It’s important to note, however, that most of the research is being done on diseases and disorders, not specifically weight loss. That doesn’t mean there hasn’t been evidence of weight loss as a benefit of the eating pattern, just that the studies performed specifically for the benefits for long-term weight loss are limited. There’s anecdotal evidence out there, of course, but there was evidence of weight loss associated with a low-fat diet in the '90s… until that farce came falling down around our collective shoulders as the long-term evidence came rolling in to the contrary.
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.

Studies are emerging that ketogenic diets (in conjunction with other treatments) can either reverse progressive brain disorders or help repair the damage. These include traumatic brain injuries and neurodegenerative diseases like Alzheimer’s and Parkinson’s. The Wahl’s Protocol also utilizes this benefit of the ketogenic diet to help repair neurological damage from multiple sclerosis.
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