There are many ways in which epilepsy occurs. Examples of pathological physiology include: unusual excitatory connections within the neuronal network of the brain; abnormal neuron structure leading to altered current flow; decreased inhibitory neurotransmitter synthesis; ineffective receptors for inhibitory neurotransmitters; insufficient breakdown of excitatory neurotransmitters leading to excess; immature synapse development; and impaired function of ionic channels.
Macronutrient ratios are very important on a ketogenic diet. The macro ratios on a keto diet typically look like this (for simplicity’s sake, the following percentages are based on the standard ketogenic diet approach):
A: Although desirable, there’s no requirement to eat organic or grass fed. Just get whatever cheap meat and veggies and eggs you can find. Frozen is usually cheaper and wait till something’s on sale and stock up. You don’t need to buy all the fancy things like nut flours, MCT oil, psyllium husk, xantham gum etc. Just keep meals simple and it can all be easy and cheap.
Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose). Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.
On a ketogenic diet, you’re generally eating a diet that’s high in fat (roughly 70 percent of your total calories come from fat), moderate in protein (about 20 percent of your calories), and low in carbohydrate (about 5 percent of calories). By limiting carbohydrates (to usually less than 45 grams for the average person), your body lacks the glucose (from carbs) that it normally uses for energy, so it eventually switches over to burning fat as its primary fuel source instead; through a metabolic process called ketosis, the liver converts the fat into fragments of fatty acids called ketones, which power the brain and other organs and tissues.
The classic ketogenic diet is not a balanced diet and only contains tiny portions of fresh fruit and vegetables, fortified cereals and calcium-rich foods. In particular, the B vitamins, calcium and vitamin D must be artificially supplemented. This is achieved by taking two sugar-free supplements designed for the patient’s age: a multivitamin with minerals and calcium with vitamin D. A typical day of food for a child on a 4:1 ratio, 1,500 kcal (6,300 kJ) ketogenic diet comprises:
Getting started is simple: just dive in! It’s always good to spend some time cleaning out your kitchen pantry and adding in new staples. Check out our recommendations to start if you’re new and not sure what to get.
Because the ketogenic diet alters the body’s metabolism, it is a first-line therapy in children with certain congenital metabolic diseases such as pyruvate dehydrogenase (E1) deficiency and glucose transporter 1 deficiency syndrome, which prevent the body from using carbohydrates as fuel, leading to a dependency on ketone bodies. The ketogenic diet is beneficial in treating the seizures and some other symptoms in these diseases and is an absolute indication. On the other hand, it is absolutely contraindicated in the treatment of other diseases such as pyruvate carboxylase deficiency, porphyria and other rare genetic disorders of fat metabolism. A person with a disorder of fatty acid oxidation is unable to metabolise fatty acids, which replace carbohydrates as the major energy source on the diet. On the ketogenic diet, their body would consume its own protein stores for fuel, leading to ketoacidosis, and eventually coma and death.
Although there are a variety of symptoms that can arise during keto adaptation, they mostly manifest from the same three underlying causes. Hypoglycemia (low blood sugar), Hypothalamic-Pituitary-Adrenal (HPA) axis dysfunction, and electrolyte/mineral deficiencies.
Although a standard ketogenic diet is even more restrictive in terms of carb intake, a “moderate keto diet” is another option that will very likely still be able to provide substantial weight loss results and other improvements in symptoms. Including slightly more carbs can be very useful for maintenance, allow for more flexibility, provide a higher fiber intake, and overall may feel more sustainable long term socially and psychologically.
Use a Magnesium Supplement: Unless you are experiencing diarrhea, a magnesium supplement can work great for helping balance electrolytes and hydration levels. As you can see, magnesium can help keto-adaptation in many ways. Using 1 gram of the L-threonate form 3x daily is my general recommendation. If diarrhea occurs, lower to once or twice a day until it subsides.
Below you’ll find a quick visual guide on the best (and worst) low-carb vegetables for keto. Keep scrolling down to see a complete list of the most commonly consumed vegetables. At the bottom of this page, you’ll find a list of the top 10 vegetables to consume based on scientific facts.
Many people choose to use a mixture of the higher carb vegetables with lower carb ingredients. It’s a great flavor enhancer, but you don’t want over-saturate your diet with carby vegetables. Next time you’re in the mood for something a bit more on the sweet side, consider making one of the following:
For ideas and inspiration on how to reach your macros, take a look at our ever-growing library of keto recipes. If you don’t want to do all of the planning yourself, consider getting detailed shopping lists and months of meal plans made for you with Our Keto Academy >
This is just a simple and barebones version of a ketogenic diet food list. It will then be your choice to decide whether some things are worth purchasing, like diet sodas, for example. Always read the food labels to make sure they are low in carbs!
A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital and followed-up by a report published in 2001. As with most studies of the ketogenic diet, there was no control group (patients who did not receive the treatment). The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction and 3% were seizure-free.[Note 7] At twelve months, 55% were still on the diet, 23% had a good response, 20% had an excellent response and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three and four years was 39%, 20% and 12% respectively. During this period the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free but had had an excellent response.
A Florida doctor, Oliver Di Pietro, has been offering this tube diet to anyone who can pay the $1,500 cost. According to a 2012 local news report, Di Pietro learned of the diet while on a trip to Italy. He insists the keto diet is safe and effective, even for those wanting to shed just a few pounds.
Avoid eating synthetic ingredients in processed foods. Also try to limit “low-carb foods” that are still unhealthy and difficult to digest, even those that many ketogenic diet programs might recommend or include. These include cold cuts, processed meats (especially pork) or cured meats, bacon, and processed cheeses.
Ok. I have MCT oil. It’s day six. I got a metallic taste in my mouth last night (day 5), and have had 2 hypoglycemia attacks over night (took small amount of OJ and some 2 tbsp of flaxseed meal with half & half). Slowly felt better throughout the day. Bought just about all the adrenal support products you recommend this a.m. My main issue since last night: my heart has been pounding, non stop. I read it might be cortisol induced reflexive hypoglycemia or something? I’ve never been diagnosed with adrenal exhaustion, but I am noticing tiredness and weight gain (I’m 47). So, the adrenal exhaustion perhaps is self diagnosed (I’m know, so annoying for a physician to hear! I hate saying it myself). But, I’m wondering, if I’m just perimenopausal instead, should I continue on keto? If so, will the heart pounding resolve after a certain time? (Days? Weeks?) Plesse excuse how long this is. Just trying to anticipate questions.
If you’re still confused about what a net carb is, don’t worry – I’ll explain further. Let’s say for example you want to eat some broccoli (1 cup) – seriously my favorite and most delicious vegetable out there.
Fat and protein are your allies before drinking. Reach for a keto-friendly meal abundant in healthy fats with some protein. This powerful combination helps slow the effects of alcohol, so it delivers less of a metabolic strike to your system.
“Keto diets should only be used under clinical supervision and only for brief periods,” Francine Blinten, R.D., a certified clinical nutritionist and public health consultant in Old Greenwich, Connecticut, told Healthline. “They have worked successfully on some cancer patients in conjunction with chemotherapy to shrink tumors and to reduce seizures among people suffering from epilepsy.”
About four years ago I realized I was addicted to food. Putting that together and understanding the seriousness of what I was dealing with helped focus me. I set out to lose 100 lbs in a year. I started by counting calories and then eventually transitioned into basically a paleo, clean eating diet along with regular exercise and training. I accomplished my goal. I went from 325 to 225.
Hi Dr. Jockers. Your article is very thorough, thank you. I’ve been moving slowly into the keto diet and so far everything is good except for my stools now float. Is the higher increase in fats to blame? I’m taking digestive enzymes before each meal and I still have my gallbladder.
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 calories 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.
Since this is my full-time job, donations really help me keep afloat and allow me to post as much to the website as I do. I really appreciate any donation you want to give, but you can change the price yourself. I’ve added in $15 as the suggested price. I think that’s a very fair price considering other websites are charging in the hundreds of dollars, and I’ve seen what they are like on the inside.
We, at Okanagan Rawsome have been fans of our Super (delicious) green Coffee for the past year. freshly brewed organic coffee, freshly made almond milk or organic raw whole milk ( from our neighbours) raw cacao nibs, spinach, kale or cilantro, tumeric, maca, cayenne, and a scoop of coconut oil or butter. At your suggestion we’ve recently added collagen powder. Blend until frothy and than go for a 10 km nordic ski! Don’t worry too much about exact measurements. You will know when you’ve overdone it on the greens or the cayenne!
Brain Octane Oil (also available in the UK) from Bulletproof is made with pure C8. It provides a quick source of energy and maximum cognitive benefits. I could tell the difference when I started adding it in my coffee and smoothies, as I experienced an immediate energy boost which can be really helpful if you just started following the ketogenic diet and feel tired (remember, it take 3-4 weeks to get keto-adapted). I don’t use it every day but it helps having some before going to gym or when I need to work and concentrate.
Jump up ^ McNally MA, Pyzik PL, Rubenstein JE, Hamdy RF, Kossoff EH. Empiric use of potassium citrate reduces kidney-stone incidence with the ketogenic diet. Pediatrics. 2009 Aug;124(2):e300–4. doi:10.1542/peds.2009-0217. PMID 19596731
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.
Love cooking though I may, I still work a day job, social commitments, exercise, and all the other things everyone does, which is to say that time is scarce. Here’s one of my fast and easy dinners that you might enjoy too.
Then my wife had our second kid, we sold our house and moved across the country in a span of one month. The transition along with the lack of sleep and generally getting out of my routine really messed me up. I started sliding and my weight went back to 250. Then 275. It felt insurmountable. I got depressed. Last year I stepped on the scale to see that I weighed 365. I felt broken.
Full-fat dairy products, such as yogurt, cottage cheese, cream, sour cream, goat cheese, and other cheeses. Note: Dairy should be eaten sparingly, but when you do eat it, stick with full-fat, as it’s more filling and nutritious.
Conklin’s fasting therapy was adopted by neurologists in mainstream practice. In 1916, a Dr McMurray wrote to the New York Medical Journal claiming to have successfully treated epilepsy patients with a fast, followed by a starch- and sugar-free diet, since 1912. In 1921, prominent endocrinologist H. Rawle Geyelin reported his experiences to the American Medical Association convention. He had seen Conklin’s success first-hand and had attempted to reproduce the results in 36 of his own patients. He achieved similar results despite only having studied the patients for a short time. Further studies in the 1920s indicated that seizures generally returned after the fast. Charles Howland, the parent of one of Conklin’s successful patients and a wealthy New York corporate lawyer, gave his brother John a gift of $5,000 to study “the ketosis of starvation”. As professor of paediatrics at Johns Hopkins Hospital, John Howland used the money to fund research undertaken by neurologist Stanley Cobb and his assistant William G. Lennox.
We all have questions. Questions about Ketogenic foods, how our bodies react to ketosis, what we can and can’t do, how much of whatever to take in, whether or not we’re missing something. We know you’ve got ’em – so, give ’em to us!
Lastly, if you’re active, you might need to make some adjustments to take that into account. “For the first one to two weeks, temporarily reducing your exercise load can be helpful as your body adjusts to being in ketosis,” he says. “Additionally, for those who have an intense workout schedule, carb cycling may be a good option.” Carb cycling essentially means you’ll increase your carb intake on the days you’re doing exercise, ideally just two to three days per week. “While low-carb days may be around 20 to 30 grams of net carbs daily, high-carb days can range all the way up to 100 grams, although it can vary based on your size and activity level,” says Dr. Axe. (Related: 8 Things You Need to Know About Exercising on the Keto Diet.)
Consider Using Exogenous Ketones: Providing pre-formed ketones takes stress off of the body and improves the bodies ability to use ketones as a fuel sources. This, in turn, improves the bodies ability to make its own ketones and speeds up the keto adaptation process. The best is when you take exogenous ketones with adaptogens which help stabilize blood sugar, improve the stress response and support your brain. I recommend Keto Edge as the best all round exogenous ketone, adaptogen mix.
If you keep your intake in check, you may still notice an increase in weight because of glycogen stores refilling. Many people find they stick to keto or a low-carb diet simply because it makes them feel better.
Don’t Calorie Restrict – While adapting to a keto diet it may help you adjust by not restricting your calories, even if your only goal is weight loss. Calorie restriction will be easier, and even happen naturally, when your body becomes more accustomed to the diet.
The best type of vegetables for a ketogenic diet are both high in nutrients and low in carbohydrates. As most of you can guess, these are dark and leafy. Anything that resembles spinach or kale will fall into this category and will be the best vegetable to include into dishes/meals.
Feel free to add sweetener and spices to this if you’re not the biggest fan of the taste. Cinnamon, stevia, vanilla extract. Whatever you’d like to make it great tasting. You can even switch up the taste each and every day so you don’t get bored!
Finally are there any strategies you can recommend for someone like myself who deals with chronic sleep debt via jet lag and night work schedules that I can further address with supplements and/or a Keto lifestyle. I also do IF but am a little stumped as to how to proceed when I’m dealing in multiple time zones.