Ketogenic Diet Therapy
If you have been diagnosed with epilepsy, physicians of the Jefferson Comprehensive Epilepsy Center may utilize a ketogenic diet therapy to help control the number of seizures you experience, when traditional medical or surgical procedures prove unsuccessful. What Does Ketogenic Diet Therapy Involve? Developed in 1921, physicians discovered that patients who fasted had fewer seizures. Since prolonged fasting is not practical, the concept of the diet is to "trick" the brain into reacting as though fasting was still in progress with dietary modification. The dietary modification "trick" relies upon forcing the body to convert fat to ketones. Ketones, in turn, are used by the brain as an energy source when its normal fuel, glucose, is unavailable. The ketogenic diet makes glucose unavailable to the brain by restricting access to the carbohydrate foods. Possible Side Effects of Ketogenic Diet Therapy Like all treatments for epilepsy, the ketogenic diet has side effects which may or may not affect a particular individual. Some side effects can be easily managed if caught early; knowing what to look for can make a difference. A common side effect is constipation. Some ketogenic diet plans restrict fluid and lead to significant problems with dehydration, kidney stones and gallstones, but that has not been a great difficulty for Jefferson patients – we do not restrict fluid. Women on the diet may have irregular menstrual cycles. If you are family planning, it is not recommended that you follow the ketogenic diet. There have been reports of decreased bone density on the diet, and a DEXA scan or bone density scan will be performed while you are on the diet. There are also concerns about the possibility of elevation in cholesterol and lipids; lipid levels will be followed closel Continue reading >>
Therapeutic Ketogenic Diets: Evidence From The Experts
What names come to mind when you hear the term "Ketogenic Diet Expert"? For me, that list includes researchers Steve Phinney, PhD, Jeff Volek, PhD, RD, Thomas Seyfried, PhD, Adrienne Scheck, MD, Eugene Fine, MD, Dominic D'agostino, PhD, and Colin Champ, MD. There are many others who've conducted studies on ketogenic diets or use them in practice and understand their benefits -- and limitations -- for metabolic and therapeutic purposes. Although I understand the science, have read much of the work of the people listed above, and have worked with several clients who choose to follow a very-low-carbohydrate ketogenic diet, at this point I wouldn't consider myself an expert in this area. In fact, I've spent the last year or so clarifying that my own approach to diabetes and weight management is low carb but not necessarily ketogenic. I make this distinction because I believe a very-high-fat ketogenic diet isn't necessary and in some cases can be counterproductive for weight loss and blood glucose control if energy/calorie intake from fat is too high. I find that a diet moderately high in protein and fat with limited carbohydrates (25-70 grams digestible or "net" carbs per day, depending on the person) works best for most. It's also the type of diet I've followed for several years, with great results. "The More Fat You Eat, The More Fat You'll Lose"? Now, a ketogenic diet containing less than 20 grams of net carb daily can produce weight loss provided energy intake is reduced, which often occurs spontaneously with carb restriction. There's no denying that many people experience dramatic weight loss with minimal carb intake, are able to maintain the loss, and feel great eating this way. But some of the statements I've read about keto being a miracle for dropping unwanted poun Continue reading >>
Beyond Weight Loss: A Review Of The Therapeutic Uses Of Very-low-carbohydrate (ketogenic) Diets
Go to: Introduction During recent years, an increasing amount of evidence has accumulated in the literature, suggesting that very-low-carbohydrate ketogenic diets (VLCKD) could have a therapeutic role in numerous diseases. The use of VLCKD in treating epilepsy has been well established for many decades and these diets have become even more widely known, as they became popular in the 1970s for weight loss—especially as the ‘Atkins Diet'.1 More recently, the therapeutic use of ketogenic diets in other diseases has been studied with positive results—it is an important direction for research because, clearly, if nutritional intervention can reduce reliance on pharmaceutical treatments it would bring significant benefits from an economic as well as a social point of view given the current US $750 billion annual cost of pharmaceuticals.2 Ketogenic diets are characterized by a reduction in carbohydrates (usually to less than 50 g/day) and a relative increase in the proportions of protein and fat.3 The knowledge regarding the metabolic effects of classic ketogenic diets originates from the pioneering work of Cahill and colleagues in the 1960s,4 but the realization of the importance of these diets from a clinical point of view can be traced back to the early 1920s when they began to be successfully used in the treatment of epilepsy.5 There even appears to be a reference to its use in the Bible in the story of the cured epileptic (New Testament, Matthew 17:14–21). Alongside the huge amount of data about the influence of correct nutrition on health status and disease prevention (encapsulated in various nutritional guidelines delivered by public health committees worldwide), there is also ample evidence to support the notion that a low-carbohydrate diet can lead to an impro Continue reading >>
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What Is Ketogenic Therapy?
An Introduction to Ketogenic Therapy The history of the ketogenic diet begins in biblical times, when fasting was used to cure what were known as "fits". Later, in the early 1900's abstaining from food for several days was found to result in cessation of seizing activity. However, while fasting did have temporary benefits, it could not be used to treat seizures indefinitely. Since then, many researchers have studied the effects of fasting on seizures, but the development of the Ketogenic Diet can be credited to Dr. R.M. Wilder at the Mayo Clinic in Minnesota. His idea for the diet stemmed from the knowledge that during starvation, the body undergoes a state of ketosis. Ketosis is the result of fat being burned in the presence of little carbohydrate. Examples of ketones are beta-hydroxybutyric acid, acetone, and acetoacetic acid. Therefore in 1921, Dr. Wilder proposed a diet that was high in fat and low in carbohydrate to produce ketosis in the body that could be maintained on a long term basis1. Ketogenic Therapy: An In-Depth Look Although this therapy has been in existence for a long time, its popularity has both waxed and waned and the mechanism of how ketone bodies function to reduce epileptic activity is still unknown. Currently, the way in which the therapy is administered is by prescribing a diet to a patient to be followed as rigidly as one would follow a prescription for a drug. The diet prescription is made up of several components including an allotment of adequate calories, protein, and nutrients for each individual. Supplementation is commonly employed to meet nutrient needs. The strength of the diet prescription (what would be comprable to a dosage amount in medication) is gauged by the ratio of fat in grams to grams of proteins summed with grams of carbohy Continue reading >>
Who Is Ketogenic Therapy Suitable For?
Ketogenic therapy should be considered as a treatment for epilepsy after two appropriate anticonvulsant medications have failed to be effective or produced unacceptable side effects. This treatment has been shown to be successful in treating a wide range of seizure types and syndromes (references 1, 2, 3) although may be particularly beneficial in myoclonic epilepsies, infantile spasms and tuberous sclerosis complex (reference 4). Guidelines from the UK National Institute for Health and Care Excellence (NICE), updated in 2012, recommend ‘Refer children and young people with epilepsy whose seizures have not responded to appropriate anti-epileptic drugs to a tertiary paediatric epilepsy specialist for consideration of the use of a ketogenic diet.’ (The ketogenic diet is a first-line treatment for the neurometabolic diseases glucose transporter type 1 (GLUT1) deficiency syndrome and pyruvate dehydrogenase (PDH) deficiency. Although clinical evidence is more limited, ketogenic therapy is also increasingly being explored as a treatment option for other disorders such as neurological cancers. The traditional or modified ketogenic diets should not be used in individuals who have fatty acid oxidation defects, pyruvate carboxylase deficiency, primary carnitine deficiencies, organic acidurias, defects in ketone metabolism, disorders that require high dietary carbohydrates as part of their treatment, severe liver disease or hypoglycaemia under investigation (4). They should be used with caution in those with a history of renal stones, hyperlipidemia, severe gastro-oesophageal reflux, diabetes mellitus and parent or care-giver non-compliance. Concomitant steroid use will limit ketosis. Although possible, they will be more difficult to implement if there are pre-existing dietary Continue reading >>
Dr. Gonzalez Dismantles The Ketogenic Diet For Cancer [13 Mins.]
In early 2012, I started to see some chatter online about the ketogenic diet as a potential anti-cancer diet. I’ve understood for many years that different diets work for different people, and I was intrigued by the ketogenic diet for cancer. Could this be another possible dietary strategy to heal cancer? So naturally I shared information about it on this site, thinking it might be a viable option for some. At that time there were no other sites (at least none as large as this one) talking about the ketogenic diet and how it may help cancer patients. In 2013, awareness of the keto diet exploded. This was mostly due to Dr. Mercola’s articles, interviews, and endorsement. Since then, many others have jumped on the bandwagon. And at first glance, there is a compelling hypothesis which presents the ketogenic diet as a method to starve cancer cells of their primary fuel, glucose, thus killing the cancer. Despite the zealous promoters of it, some of whom I have great respect for, my opinion of the ketogenic diet has changed. What caused my change of heart in promoting the ketogenic diet for cancer patients? It started with several long phone conversations and email exchanges I had with cancer healing expert friend who was adamant that the ketogenic diet did not work in healing cancer long term. This coincided with the recurrence of cancer in someone I knew who was promoting the ketogenic diet (as effective). It appeared to have some positive short term results for some people (shrinking or slowing down tumors), but I was beginning to have some doubts about it working long term. This uneasiness persisted for many months and I could not shake it. So I finally made the decision to take down my very popular post and youtube video about it. Then came the coup de grace from Dr. Continue reading >>
The ketogenic diet is one treatment option for children with epilepsy whose seizures are not controlled with AEDs. The diet may help to reduce the number or severity of seizures and can often have positive effects on behaviour. Up to 70% of people with epilepsy could have their seizures controlled with anti-epileptic drugs (AEDs). For some children who continue to have seizures, the ketogenic diet may help. However, the diet is very specialised. It should be carried out with the care, supervision and guidance of trained medical specialists. What is the ketogenic diet? The ketogenic diet (KD) is a high fat, low carbohydrate, controlled protein diet that has been used since the 1920s for the treatment of epilepsy. The diet is a medical treatment and is usually only considered when at least two suitable medications have been tried and not worked. The ketogenic diet is an established treatment option for children with hard to control epilepsy. Some adults may benefit from dietary treatments, but more data is needed about the impact and results for adults, and adult treatments are currently only available in a few UK clinics. Dietary treatments for epilepsy must only be followed with the support of an experienced epilepsy specialist and dietitian (food specialist). How does the diet work? Usually the body uses glucose (a form of sugar) from carbohydrates (found in foods like sugar, bread or pasta) for its energy source. Chemicals called ketones are made when the body uses fat for energy (this is called ‘ketosis’). The body uses ketones instead of glucose for its energy source. Research in 2015 has shown that another chemical, decanoic acid, is also produced as a result of the diet. These chemicals help to reduce seizures for some people. Who is the diet suitable for? The Continue reading >>
The Ketogenic Diet: Does It Live Up To The Hype? The Pros, The Cons, And The Facts About This Not-so-new Diet Craze.
If you believe the buzz, ketosis — whether via the almost-zero-carb ketogenic diet or via ketone supplements— can curb appetite, enhance performance, and cure nearly any health problem that ails you. Sound too good to be true? It probably is. Want to listen instead of read? Download the audio recording here… ++++ Wouldn’t it be awesome if butter and bacon were “health foods”? Maybe with a side of guacamole and some shredded cheese on top? “I’m doing this for my health,” you could purr virtuously, as you topped your delectably marbled, medium-rare steak with a fried egg. Well, many advocates of the ketogenic diet argue exactly that: By eating a lot of fat and close to zero carbohydrates you too can enjoy enhanced health, quality of life, performance, brain function, and abs you can grate that cheese on. So, in this article, we’ll explore: What are ketones, and what is ketosis? What, exactly, is a ketogenic diet? What evidence and scientific research supports the ketogenic diet? Do ketone supplements work? Is the ketogenic diet or ketone supplementation right for me? How to read this article If you’re just curious about ketogenic diets: Feel free to skim and learn whatever you like. If you want to change your body and/or health: You don’t need to know every detail. Just get the general idea. Check out our advice at the end. If you’re an athlete interested in performance: Pay special attention to the section on athletic performance. Check out our advice for athletes at the end. If you’re a fitness pro, or interested in geeking out with nutritional science: We’ve given you some “extra credit” material in sidebars throughout. Check out our advice for fitness pros at the end. It all started with the brain. If you’ve called Client Care at Pr Continue reading >>
What Are Ketogenic Diets? Can They Treat Epilepsy And Brain Cancer?
Ketogenic diets are back in the news with claims they are a “cure-all”. Research shows that in epilepsy not controlled by current treatment, around 50% of children and adults following ketogenic diets have a reduction in seizures. For brain cancer, most research has been in animals. A number of human trials are underway testing safety, tolerance, interactions with other treatments, side-effects and the impact on cancer progression, quality of life and survival. So what are ketones? Although the main source of energy for the body is usually carbohydrate, which gets converted to blood glucose during digestion and metabolism, the body can also burn fat for energy. Ketone bodies, or ketones for short, are molecules produced by the liver when fat is metabolised. Ketones are used as the fuel source to produce energy for the body when glucose is not available. The three ketone bodies resulting from fat metabolism are acetoacetate, β-Hydroxybutyrate and acetone. Acetoacetate spontaneously converts to acetone, which is easily vaporised. Acetone crosses lung membranes and gets expired on your breath. That’s why people who are ketotic, meaning ketones are their primary fuel source, often have a “nail polish” odour. As blood levels of ketones rise, acetoacetate and β-Hydroxybutyrate cross the blood-brain barrier to become the main source of fuel for the brain. Ketones also appear in urine. Their presence is tested for using “keto” strips that change colour from buff to pink to maroon, depending on the concentration. It’s thought the metabolic changes associated with being “ketotic”, in combination with lower blood levels of glucose, are the important issues in epilepsy and cancer. What is a ketogenic diet? Ketogenic diets should only be used as part of medical Continue reading >>
15 Health Conditions That May Benefit From A Ketogenic Diet
Ketogenic diets have become incredibly popular. Early research suggests this high-fat, very low-carb diet may benefit several health conditions. Although some of the evidence is from case studies and animal research, results from human controlled studies are also promising. Here are 15 health conditions that may benefit from a ketogenic diet. Epilepsy is a disease that causes seizures due to excessive brain activity. Anti-seizure medications are effective for some people with epilepsy. However, others don't respond to the drugs or can't tolerate their side effects. Of all the conditions that may benefit from a ketogenic diet, epilepsy has by far the most evidence supporting it. In fact, there are several dozen studies on the topic. Research shows that seizures typically improve in about 50% of epilepsy patients who follow the classic ketogenic diet. This is also known as a 4:1 ketogenic diet because it provides 4 times as much fat as protein and carbs combined (1, 2, 3). The modified Atkins diet (MAD) is based on a considerably less restrictive 1:1 ratio of fat to protein and carbs. It has been shown to be equally effective for seizure control in most adults and children older than two years of age (4, 5, 6, 7, 8). The ketogenic diet may also have benefits on the brain beyond seizure control. For example, when researchers examined the brain activity of children with epilepsy, they found improvements in various brain patterns in 65% of those following a ketogenic diet — regardless of whether they had fewer seizures (9). Ketogenic diets have been shown to reduce seizure frequency and severity in many children and adults with epilepsy who don't respond well to drug therapy. Metabolic syndrome, sometimes referred to as prediabetes, is characterized by insulin resistance. Continue reading >>
How The Ketogenic Diet Weakens Cancer Cells
Chronic disease continues to ravage our world today despite tremendous advances in health care. Therapeutic approaches to treating this wide-range suffering cannot be met by technological growth in pharmacology, genetic therapy, or surgery. It should be obvious that the real solution for treating cancer and disease is not found in a man-made pill but rather is found in regulating the metabolic functions within our bodies. Western cultures today enjoy a diet rich in the delicacies that our ancestors did not consume on a regular basis such as grain, sugar, and starch. Research continues to show that sugar is the main source of fuel which feeds cancer and contributes to an inflammatory environment. Sugar essentially increases the risk for cancer and disease. How the Ketogenic Diet Works What is the Ketogenic Diet? The Eskimos and Maasai group are cultures we often look at to learn how their scant consumption of carbohydrates sustained their bodies through harsh weather conditions. It turns out that their low carb diet switched their metabolism to burn fat instead of sugar or glucose. This created a metabolic state known as ketosis, a process in which the body burns ketones to make energy, instead of relying on sugar or carbohydrate. Ketones are metabolized by fatty acids in the liver for energy. (This source of fuel is capable of crossing the blood brain barrier and is an excellent form of energy for neurons.) When the body lacks glucose, which is its first source of fuel, ketones are created in its absence. Ketosis was a beneficial process the human body developed as an adaptation to times when food was unavailable (such as for these hunter-gatherers). However, you can effectively produce ketones too by limiting the carbohydrates in your diet to less than 80 grams daily a Continue reading >>
What is the ketogenic diet? The "classic" ketogenic diet is a special high-fat, low-carbohydrate diet that helps to control seizures in some people with epilepsy. It is prescribed by a physician and carefully monitored by a dietitian. It is usually used in children with seizures that do not respond to medications. It is stricter than the modified Atkins diet, requiring careful measurements of calories, fluids, and proteins. Foods are weighed and measured. The name ketogenic means that it produces ketones in the body. (keto = ketone; genic = producing) Ketones are formed when the body uses fat for its source of energy. Usually the body uses carbohydrates (such as sugar, bread, pasta) for its fuel. Because the ketogenic diet is very low in carbohydrates, fats become the primary fuel instead. The body can work very well on ketones (and fats). Ketones are not dangerous. They can be detected in the urine, blood, and breath. Ketones are one of the more likely mechanisms of action of the diet, with higher ketone levels often leading to improved seizure control. However, there are many other theories for why the diet will work. Who will it help? Doctors usually recommend the ketogenic diet for children whose seizures have not responded to several different seizure medicines. The classic diet is usually not recommended for adults, mostly because the restricted food choices make it hard to follow. However, the modified Atkins diet does work well. This also should be done with a good team of adult neurologists and dietitians. The ketogenic diet has been shown in many studies to be particularly helpful for some epilepsy conditions. These include infantile spasms, Rett syndrome, tuberous sclerosis complex, Dravet syndrome, Doose syndrome, and GLUT-1 deficiency. Using a formula-only Continue reading >>
Pediatric Ketogenic Diet
A ketogenic diet is a high-fat, adequate-protein, and very-low-carbohydrate diet which has been found to help many children whose seizures are not well-controlled by anti-seizure medications. In some children, the ketogenic diet is combined with standard anticonvulsant medications. While the actual mechanism of the ketogenic diet's effectiveness against seizures is unknown, many children on the diet are able to have their epilepsy medication dose lowered, decreasing unwanted medication side effects. We are consistently ranked among the top hospitals in U.S.News & World Report, distinguished for our pediatric care. Read More Because this is a medical treatment, the ketogenic diet must be supervised by a medical team, consisting of a neurologist and dietitian, who can anticipate and manage possible nutritional deficits or other medical side effects or complications. The team helps children and their families establish and maintain the diet, and learn how to incorporate the diet into daily living. Children on the ketogenic diet are seen several times throughout the year for close monitoring, while they continue to follow with their primary neurologist for potential medication changes. In addition, the team also implements the Modified Atkins Diet and Low-Glycemic Index Therapy, other dietary therapies for which there is increasing data about benefit in the treatment of difficult-to-treat epilepsy. Conditions treated by the Ketogenic Diet Team include: Epilepsy such as Myoclonic Astatic Epilepsy and other epilepsies Glucose transporter type-1 deficiency Lennox Gastaut syndrome Pyruvate dehydrogenase deficiency Dravet syndrome What is a ketogenic diet? The ketogenic diet is sometimes offered to children who continue to have seizures while on seizure medication. When medicati Continue reading >>
Ketogenic Therapy Effects On Electrical And Metabolic Abnormalities In Epilepsy
Approximately a fourth of children with seizures do not respond adequately to available therapy. Ketogenic therapy has a long history as treatment for intractable epilepsy, but there is no agreement concerning how it works and what is the best way to administer it. This natural history study will collect data pertaining to both questions. The basis of Ketogenic Therapy is an altered macronutrient intake. It is based on a ratio of fat: protein+carbohydrate in which protein intake is adequate and carbohydrate is minimal. On Ketogenic Therapy, the body metabolizes fat, producing ketones as an energy source for the brain. Induction of ketosis has been shown to correlate with the reduction of seizures observed with Ketogenic Therapy. A major challenge of Ketogenic Therapy in children is that the compounds provided to stop seizure activity are the same compounds provided for growth and development. The altered macronutrient ratio that is the basis of Ketogenic Therapy is also a potential risk factor for dyslipidemia and may adversely affect growth. The investigators will evaluate efficacy of Ketogenic Therapy by assessing seizures and requirements for antiepileptic drugs. The investigators will evaluate adverse effects of Ketogenic Therapy by assessing dyslipidemia and growth. The investigators will foster optimal daily administration of therapy with structured training programs for caregivers. Study Type : Interventional (Clinical Trial) Estimated Enrollment : 200 participants Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment Official Title: Ketogenic Therapy Effects on Electrical and Metabolic Abnormalities in Epilepsy Study Start Date : September 2006 Estimated Primary Completion Date : September 2018 Estimated Study Completi Continue reading >>
Side Effects Of Ketogenic Therapy
Early side effects During initiation of ketogenic therapy there is a risk of hypoglycaemia, acidosis, dehydration and high levels of ketones (1). Children on carbonic anhydrase inhibitor medications (for example, topiramate or zonisamide) may have increased risk of excess ketosis and metabolic acidosis on commencing ketogenic therapy (2). Nutrition and growth Children with drug resistant epilepsy are at risk of insufficient vitamin D status prior to starting ketogenic therapy (3) and although levels can be normalised with vitamin D supplementation, a decline in both whole body and spine bone mineral content while on the ketogenic diet has been reported (4) despite reduction in anticonvulsant medication. Selenium deficiency can occur in children on the ketogenic diet (5) with risk of impaired myocardial function (6). Low plasma magnesium has also been reported (1) and may be a particular problem in children on the classical diet despite micronutrient supplementation (7). Vitamin C deficiency was found in one child on the ketogenic diet (8) but plasma levels of fat soluble vitamins A and E can often be raised as a consequence of a high fat intake (7). A fall in carnitine status of children and young adults during the first few months of the ketogenic diet has been seen with some cases requiring supplementation (9), although levels tended to normalise with time on diet therapy. There is evidence of impaired growth in children on the ketogenic diet (10, 11, 12); younger children may be more at risk (13). Despite the higher protein allowance of the medium chain triglyceride (MCT) diet, no differences were seen in the growth of children on this diet compared to the lower-protein classical diet (14). Long-term follow up of children treated with the ketogenic diet in the past s Continue reading >>