The nerve impulse is characterised by a great influx of sodium ions through channels in the neuron's cell membrane followed by an efflux of potassium ions through other channels. The neuron is unable to fire again for a short time (known as the refractory period), which is mediated by another potassium channel. The flow through these ion channels is governed by a "gate" which is opened by either a voltage change or a chemical messenger known as a ligand (such as a neurotransmitter). These channels are another target for anticonvulsant drugs.[7]

Although the exact role of the keto diet in mental and brain disorders is unclear, there has been proof of its efficacy in patients with schizophrenia. And, to boot, it works to reverse many conditions that develop as a side effect of conventional medications for brain disorders, like weight gain, type 2 diabetes and cardiovascular risks. More research is needed to understand the role of the ketogenic diet in treating or improving schizophrenia, as the current available studies are either animal studies or case studies, but the benefits of a low carbohydrate, high-fat diet in neurology is promising.

The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. Some evidence of synergistic benefits is seen when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[18]

If you are looking for a healthy cooking oil, extra virgin olive oil should be your staple. A recent study found this to be the healthiest oil for baking, cooking, and deep frying at high temperatures. This is because extra virgin olive oil contains a high-quantity of stable fats and antioxidants that protect the oil from breaking down into toxic chemicals.

O n e Y e a r : Thankful for the Gospel and it’s power to transform all areas of life. Only God’s grace allows me to look back one year ago (almost to the day) to reflect on how far He’s actually brought me and my family. Lots of “negative” circumstances took place over the course of the last year, but the perspective of the guy on the left is VASTLY different from the guy on the right. I truly believe there are no negative circumstances in this life, only misunderstandings of what’s actually good (dare I say, “best”) for us. Keep pressing on, keep pursuing, keep searching for the only One worth anchoring your hope to. | #wonthedoit #godisgoodallthetime #stewardshipoflife #identity #hope #fattofitjourney #50lbsandcounting #Keto
First reported in 2003, the idea of using a form of the Atkins diet to treat epilepsy came about after parents and patients discovered that the induction phase of the Atkins diet controlled seizures. The ketogenic diet team at Johns Hopkins Hospital modified the Atkins diet by removing the aim of achieving weight loss, extending the induction phase indefinitely, and specifically encouraging fat consumption. Compared with the ketogenic diet, the modified Atkins diet (MAD) places no limit on calories or protein, and the lower overall ketogenic ratio (about 1:1) does not need to be consistently maintained by all meals of the day. The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet. Carbohydrates are initially limited to 10 g per day in children or 20 g per day in adults, and are increased to 20–30 g per day after a month or so, depending on the effect on seizure control or tolerance of the restrictions. Like the ketogenic diet, the MAD requires vitamin and mineral supplements and children are carefully and periodically monitored at outpatient clinics.[48]
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While keto diets minimize sugar and other food sensitivities, they often allow full-fat dairy such as yogurt that, for some people, can stall fat loss. And some packaged keto-friendly foods (yes, there's a whole industry of keto-friendly cookies, candy, and other junk food!) can contain gluten, artificial sweeteners, and other reactive ingredients. These foods and additives cause dysbiosis (an imbalance between good and bad bugs), leaky gut syndrome, and increase insulin resistance, which raises blood sugar levels—stalling weight loss. Read your labels carefully: Food sensitivities can be sneaky and hide in foods that you would never suspect, like mustard.
But your heart health might depend on what you actually eat. Research published in the New England Journal of Medicine suggests that low-carb diets based mostly on plant sources of fat and protein (like avocados or nuts) can lower heart disease risk by 30 percent. But those benefits didn’t hold for people who ate mostly animal-based proteins and fats. (Think: bacon, butter, and steak.)
However, maintaining muscle mass and its functionality (i.e., muscle strength) has an important role in preventing weight regain, maintaining physical functionality, improving cardiometabolic risk factors, and reducing cardiovascular outcomes (5, 7–9, 32, 33). It is commonly assumed, and stated in several textbooks on obesity, that weight loss is associated with an important loss of muscle mass that evolves in parallel with the fat reduction. Some dietary guidelines have even suggested that diets that induce rapid weight loss, such as VLCK diets, create a greater energy deficit and contain lower amounts of protein, and therefore increase the risk of reductions in muscle mass compared with other interventions with more gradual weight loss (34, 35). In this article it was shown that the reductions observed in lean mass were mostly a result of body water loss, both intra- and extracellular. The combined information from the DXA and MF-BIA methods allows for such differentiation (28, 36–38). The loss attributable to muscle mass was minimal (∼1 kg), and an absolute preservation of HG strength was observed, a remarkable fact considering that the patients have experienced a weight reduction of ∼20 kg.
Use fat as a lever.  We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied.
“I have been recommending low-carb and ketogenic diets to my family practice and consultation patients since early 2017. Diet Doctor is an incredibly valuable resource for my patients; counseling low-carb would be much more difficult without all the great information available. My orthopaedic pre-habilitation, diabetes, mood disorder, Alzheimer’s, PCOS, cancer, and obese patients all benefit from low-carb. Low-carb has brought back the joy in family medicine!”
If you want to try a ketogenic diet, be aware that you'll have to adjust it for your individual metabolism and experiment with the right balance of carbs and calories. While some low-carbohydrate dieters find they are able to break stalls in their weight loss, others find that it is more difficult for them to stay in this state. You may want to consult a registered dietitian to build keto-friendly menus for you that will meet your nutritional needs. Be sure to keep your health care provider informed when you start a new diet, especially if you have ongoing health conditions.
I ate a lot of bacon, cheese, eggs and meat (steak and chicken mostly). For a person whose eating philosophy is typically more plant-based and whole-food-focused, eating processed pork products every morning took a lot of personal persuasion. It also took a complete mental shift, because eating multiple pieces of bacon every day for weeks on end goes against everything I've been taught for personal health.
“The totality of evidence is very clear: A low-carbohydrate dietary approach is the most effective way to manage the insulin resistance syndrome which is that single biggest driver of obesity, type 2 diabetes and cardiovascular disease. Diet Doctor has been instrumental in providing extremely useful, clear and educational material to all who want to implement this dietary approach in to their lives. That’s why I recommend the website to all my at-risk patients.”

It’s no secret that carbs—especially refined ones like sugary cereals, white bread and pasta, or sweet drinks—cause your blood sugar to spike and dip. So it makes sense that eating less of them can help keep things nice and even. For healthy people, this can translate to more steady energy, less brain fog, and fewer sugary cravings, Mancinelli explains.
It’s also currently as trendy to the fitness world as kale and açaí are to the pseudo-hipsters who wear beanies, even in the dead-heat of summer. If you haven’t tried keto on for size, maybe give it a go (unless you’re a complete and utter carb bitch, and cramming yourself full of bagels and pancakes just makes your abs really pop - in which case, the rest of us hate you on the inside. Just a little.)
I ate a lot of bacon, cheese, eggs and meat (steak and chicken mostly). For a person whose eating philosophy is typically more plant-based and whole-food-focused, eating processed pork products every morning took a lot of personal persuasion. It also took a complete mental shift, because eating multiple pieces of bacon every day for weeks on end goes against everything I've been taught for personal health.

One theory is that an extreme increase in cholesterol may be common in those undergoing rapid weight loss. This is because the fat cells we have stored in our adipose tissue contain high amounts of both triglycerides and cholesterol. When we begin to break down our stored fat to be metabolized for energy, cholesterol in the blood goes up temporarily.

Now that we have discussed the role of the primary cholesterol molecules, you should have a better understanding of how they work together. Having high LDL isn’t necessarily bad, given that you have adequate HDL to help clear it from the blood stream and that you are not dealing with chronic inflammation. It is also important to have large particle LDL (pattern A) rather than small particle LDL (pattern B).
“I am determined to shatter the chiding “eat less, exercise more” obesity medicine paradigm. Obesity is not a personal failure, but a chronic health condition unfolding in our country and around the world. It is a result of the “carboholic” society we live in. Through a holistic approach, I arm patients with knowledge, tools, and skills to manage their weight as well as their overall health.”
“I’ve studied LCHF nutrition for over 20 years for personal health benefits. In my medical practice, it has become integral to reversing many of modern society’s worst medical concerns including metabolic syndrome, obesity, and diabetes. It can be applied safely and effectively for nearly all of my patients and often results in dramatic restoration of good health.”
Recently, four studies have re-examined the effect of carbohydrate restriction on type 2 diabetes. One outpatient study enrolled 54 participants with type 2 diabetes (out of 132 total participants) and found that hemoglobin A1c improved to a greater degree over one year with a low-carbohydrate diet compared with a low-fat, calorie-restricted diet [5,6]. Another study enrolled 8 men with type 2 diabetes in a 5-week crossover outpatient feeding study that tested similar diets [7]. The participants had greater improvement in glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet. The third study was an inpatient feeding study in 10 participants with type 2 diabetes [8]. After only 14 days, hemoglobin A1c improved from 7.3% to 6.8%. In the fourth study, 16 participants with type 2 diabetes who followed a 20% carbohydrate diet had improvement of hemoglobin A1c from 8.0% to 6.6% over 24 weeks [9]. Only these latter three studies targeted glycemic control as a goal, and two of these were intensely-monitored efficacy studies in which all food was provided to participants for the duration of the study [7,8]. Three of the studies [6,8,9] mentioned that diabetic medications were adjusted but only one of them provided detailed information regarding these adjustments [9]. This information is critical for patients on medication for diabetes who initiate a low-carbohydrate diet because of the potential for adverse effects resulting from hypoglycemia.
Although in most clinical settings, BMI and waist circumference are used because they are inexpensive and convenient, it is evident that they are not able to precisely determine excess fat mass and its loss during treatment (44). More precise techniques to assess body composition are needed in specialized clinical settings and for research purposes. Therefore, another target of this work was to compare the accuracy of the information provided by the more expensive and less convenient DXA, currently considered the gold standard, with the less expensive and more convenient MF-BIA, as well as with ADP, which is only used in highly specialized centers because of its high cost (45). The results obtained showed that MF-BIA correlates very well with DXA, although with a tendency to slightly underestimate the FM%. These results are consistent with previous work that found that MF-BIA may overestimate the FFM, and thus produce an underestimation of the FM and FM% (45). MF-BIA provided highly relevant information about the water component during dieting. On the other hand, the ADP instrument showed a lower correlation with DXA and a greater variability in estimating the FM%. Compared with DXA, ADP underestimates the FM% in thinner patients, and overestimates the FM% in those patients with a higher body fat. The 3 techniques correlated remarkably well, although the less expensive MF-BIA performed with high precision.

The data are presented as mean (standard deviation). All statistical analyses were carried out using Stata statistical software, version 12.0 (Stata, College Station, TX). A P < 0.05 was considered statistically significant. Changes in the different variables of interest from baseline and throughout the study visits were analyzed following a repeated measures design. A repeated measures analysis of variance test was used to evaluate differences between different measurement times, followed by post hoc analysis with Tukey’s adjustment for multiple comparisons. In addition, linear regression analyses were used to evaluate the accuracy of MF-BIA and ADP in comparison with DXA, because DXA is considered the reference technique in the estimation of body composition in clinical research (26). Finally, the Bland-Altman approach was also used to assess the accuracy of MF-BIA and ADP against DXA in the estimation of FM%.


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Ketone bodies synthesized in the body can be easily utilized for energy production by heart, muscle tissue, and the kidneys. Ketone bodies also can cross the blood-brain barrier to provide an alternative source of energy to the brain. RBCs and the liver do not utilize ketones due to lack of mitochondria and enzyme diaphorase respectively. Ketone body production depends on several factors such as resting basal metabolic rate (BMR), body mass index (BMI), and body fat percentage. Ketone bodies produce more adenosine triphosphate in comparison to glucose, sometimes aptly called a "super fuel." One hundred grams of acetoacetate generates 9400 grams of ATP, and 100 g of beta-hydroxybutyrate yields 10,500 grams of ATP; whereas, 100 grams of glucose produces only 8,700 grams of ATP. This allows the body to maintain efficient fuel production even during a caloric deficit. Ketone bodies also decrease free radical damage and enhance antioxidant capacity.


Eating too much for your genes/environment. I was guilty of this when I first tried keto in 2015. I made coffee with pastured butter and coconut oil every morning, ate bacon and other fatty meats, and promptly gained weight. Without getting too much in the weeds, you want to aim for a less-caloric ketogenic food plan, not a hypercaloric one like I did. Calories aren’t everything—hormones matter more—but you need to be paying attention and not overeat, which, obviously, can cause you to gain weight.


The American Academy of Family Physicians defines low-carbohydrate diets as diets that restrict carbohydrate intake to 20 to 60 grams per day, typically less than 20% of caloric intake.[2] A 2016 review of low-carbohydrate diets classified diets with 50g of carbohydrate per day (less than 10% of total calories) as "very low" and diets with 40% of calories from carbohydrates as "mild" low-carbohydrate diets.[18] In a 2015 review Richard D. Feinman and colleagues proposed that a very low carbohydrate diet had less that 10% caloric intake from carbohydrate, a low carbohydrate diet less than 26%, a medium carbohydrate diet less than 45%, and a high carbohydrate diet more than 45%.[16]
Thanks for this inputs. 20 years ago I gain 17 pounds a year for 5 years. I was healthy but my dr told me start diet, any diet just come back in a month I want to see you start loosing… I started Atkins and lost 7 pound in a month. She was checking my progress every six months and checking my condition. I lost 64 pounds in 3 years. Now I started eating out of control. I am eating healthy but too much… I gain 40 pound back after 20 years. Now I will start again my Atkins to take off 30 pounds…

“I started gaining weight in college. Too Much Beer. And it didn't stop, sitting at a desk job all day, going out to dinner ever night. I packed on the pounds. I knew something had to change. My friend recommened to me. I suddenly had energy again! I started taking the stairs at work. Biking on the weekend. I've been using it for 18 months now - and let me tell you - I'm back baby! ” - Carlos Thomas
I’ve been doing keto for a month now. Cheated on Sunday to hopefully reboot this diet because I’ve only lost 3lbs. I’ve been within my carbs and doing everything right. Somehow just not loosing weight. I’ve lost 50lbs before just eating healthier so I don’t understand why this isn’t working for me? If anyone has any advice it would be helpful, I’m trying to stick this out for my mom so she stays healthy but it suck not loosing. I’m 26 and 219lbs so I have plenty of fat to loose.
The ketogenic diet is not a benign, holistic, or natural treatment for epilepsy; as with any serious medical therapy, complications may result.[28] These are generally less severe and less frequent than with anticonvulsant medication or surgery.[28] Common but easily treatable short-term side effects include constipation, low-grade acidosis, and hypoglycaemia if an initial fast is undertaken. Raised levels of lipids in the blood affect up to 60% of children[38] and cholesterol levels may increase by around 30%.[28] This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and if persistent, by lowering the ketogenic ratio.[38] Supplements are necessary to counter the dietary deficiency of many micronutrients.[18]
I think Tammy is asking about labeling on products. I have also found the percentages to be inconsistent. I think it is due to the way they companies calculate the grams in relation to the average daily intake- the result being different as the range  goes from 225-325 grams per day. At the end of the day the company decides how they calculate the percentage so the best way to solve this is to look at the grams instead.

For those looking for something just a little closer to real sugar, you can use Xylitol. It cooks and tastes very similar to sugar, but it has a slight glycemic impact (13 vs. 100 for sugar). It is great, but please keep in mind that it is very toxic to animals and it will raise insulin levels slightly. These are the two most cited reasons for not using Xylitol.
The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of goop, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.
“[This study] does support other existing research findings that you can indeed lose weight on a ketogenic-inducing diet, and higher levels of protein intake, while following a calorie-restricted diet does help preserve the loss of lean muscle mass,” says Lona Sandon, PhD, RDN, assistant professor in the department of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas.
It has been repeatedly found that in the long-term, all diets with the same calorific value perform the same for weight loss, except for the one differentiating factor of how well people can faithfully follow the dietary programme.[27] A study comparing groups taking low-fat, low-carbohydrate and Mediterranean diets found at six months the low-carbohydrate diet still had most people adhering to it, but thereafter the situation reversed: at two years the low-carbohydrate group had the highest incidence of lapses and dropouts.[27] This may be due to the comparatively limited food choice of low-carbohydrate diets.[27]
"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.
Available research on the ketogenic diet for weight loss is still limited. Most of the studies so far have had a small number of participants, were short-term (12 weeks or less), and did not include control groups. A ketogenic diet has been shown to provide short-term benefits in some people including weight loss and improvements in total cholesterol, blood sugar, and blood pressure. However, these effects after one year when compared with the effects of conventional weight loss diets are not significantly different. [10]

One area where food tracking can be especially helpful, though, is ensuring that you're hitting the right ratios of macronutrients—protein, carbs, and fat. "The most researched version of the ketogenic diet derives 70 percent of calories from healthy fats, 20 percent from protein, and only 10 percent from carbs," explains Charles Passler, D.C., nutritionist, and founder of Pure Change. "In the ideal world, each keto meal and snack should have that same (70/20/10) ratio of macronutrients, but studies have shown that you'll still achieve great results even if each meal varies slightly from that ratio, just as long as you don't exceed 50 grams per day of carbs, or eat those carbs in one sitting," says Passler. In order to achieve these ratios without a preset meal plan from a dietitian or doctor, some food tracking is probably going to be necessary. But once you get the hang of things, you may not need it anymore.


The one important caveat: Eating keto also ups the risk for diabetic ketoacidosis, a life-threatening condition where fat gets broken down too fast and causes the blood to become acidic. It’s much more common in people with type 1 diabetes, but if you have type two and are eating keto, talk with your doctor about what you should be doing to diminish your risk.
Long-term compliance is low and can be a big issue with a ketogenic diet, but this is the case with any lifestyle change.  Even though the ketogenic diet is significantly superior in the induction of weight loss in otherwise healthy patients with obesity and the induced weight loss is rapid, intense, and sustained until at least 2 year, the understanding of the clinical impacts, safety, tolerability, efficacy, duration of treatment, and prognosis after discontinuation of the diet is challenging and requires further studies to understand the disease-specific mechanisms.
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