the therapeutic ketogenic diet

A therapeutic ketogenic diet can be helpful for a range of chronic health conditions such as cancer, epilepsy, Alzheimer’s disease or dementia.

Domonic D’Agostino is doing interesting research into the possible uses for ketosis, both through diet and supplementation.  His initial funding was from the US Military to research the applications of ketosis for navy seal divers in order to avoid oxygen toxicity seizures.

He has continued this research into how ketosis can starve cancer and be used in conjunction with normal treatments to aid recovery from chemotherapy and slow tumour growth. [1]  His more recent research demonstrates that body builders can maximise their power to weight ratio and recovery using a ketogenic approach.

Dr Mary Newport has received a lot of coverage after treating her husband’s advanced Alzheimer’s with coconut oil. [2]

Terry Whals is undertaking clinical trials of her high nutrient density ketogenic diet that has worked to reverse her own multiple sclerosis.[3]

The ketogenic diet for epilepsy has made a resurgence since director Jim Abrahams [4] found success with the ketogenic diet for his son Charlie and then made a movie of his experience. [5]

The Charlie Foundation (with partner site ketocook.com) supports families working to use a ketogenic dietary approach to manage epileptic seizures. [6]

Jimmy Moore’s Keto Clarity [7] spends three chapters profiling the various conditions that the ketogenic diet has been claimed to be beneficial for.

  • Solid science (chapter 16)
    • Epilepsy
    • Diabetes mellitus
    • Weight loss
    • Polycystic ovary syndrome (PCOS)
    • Irritable bowel syndrome (IBS)
    • GERD and heartburn
    • Non-alcoholic fatty liver disease (NAFLD)
  • Good evidence (chapter 17)
    • Alzheimer’s disease
    • Parkinson’s disease
    • Dementia
    • Schizophrenia, bipolar and other mental illnesses
    • Narcolepsy and other sleep disorders
    • Exercise performance
  • Emerging areas (chapter 18)
    • Cancer
    • Fibromyalgia
    • Chronic pain
    • Migraines
    • Traumatic brain injury
    • Stroke
    • Gum disease and tooth decay
    • Acne
    • Eyesight
    • Amyotrophic lateral sclerosis (ALS)
    • Multiple sclerosis (MS) and Huntington’s disease
    • Aging
    • Kidney disease
    • Restless leg syndrome (RLS)
    • Arthritis
    • Alopecia and hair loss
    • GLUT1 deficiency syndrome

The therapeutic ketogenic diet is similar to the LCHF approach but takes it one step further, with net carbs typically restricted to 25g per day (or sometimes less) and protein restricted to the minimum necessary for muscle repair.

People trying to slow or reverse cancer growth or stop seizures will often also resort to more aggressive measures including supplementing with larger amounts of butter, coconut oil, MCT oils and ketone salts to drive their ketones to higher levels (i.e. 1.5 to 3.0mmol/L).

I figured we could use the food ranking system to prioritise foods with a low insulinogenic load over and above nutrition or the other parameters.

The table below shows the weighting I have used for this ranking.  Still considering nutrient density, cost and calorie density will help to optimise these other elements of nutrition even though we are primarily targeting a low insulin load.

ND / cal fibre / cal ND / $ ND / weight insulinogenic (%) cal / 100g $ / cal
5% 5% 5% 5% 70% 5% 5%

I have also used a filter using Wilders’ formula to show only foods that have a ratio of ketogenic to anti ketogenic calories greater than 1.5.  This is the commonly accepted parameter in therapeutic ketosis circles to determine whether a food or a meal is sufficiently ketogenic.

You could also use this calculator to check the percentage of insulinogenic calories of your food.  If you’re aiming for therapeutic ketosis you’ll probably need to have an overall average of less than 15% and any individual food should ideally have a percentage of insulinogenic calories less than 25%.

The resultant foods are listed below.  This approach will obviously prioritise liberal use of fats and oils along with higher fat dairy products and meats.

Not all of the vegetables have a Wilder’s ketogenic ratio greater than 1.5 but it would still be desirable to include adequate vegetables for nutrition as long as they give they fit your tolerances whether they be net carbs, ketones or something else.

Someone using this approach may choose to supplement vitamins and minerals or use organ meats to achieve their nutrition in order to minimise carbohydrates from the vegetables.

People battling chronic illnesses also often have allergies that will mean that they further need to refine this list.

insulin vitamins & minerals protein fibre calorie density
70% 10% 10% 5% 5%

I hope that these lists will be useful for people who need to maximise ketosis for therapeutic purposes, as well as possibly others with diabetes, insulin resistance or people looking to lose weight who want to use a more aggressive approach for a period.

fats and oils

  • butter
  • coconut oil
  • olive oil
  • fish oil
  • flax seed oil
  • lard
  • bacon grease

nuts, seeds & legumes

  • Brazil nuts
  • pecan nuts
  • peanuts
  • Macadamia nuts
  • sunflower seeds
  • coconut milk
  • pine nuts
  • almonds
  • coconut meat
  • almond butter
  • pumpkin seeds
  • almonds
  • pistachio nuts

fruit

  • avocado
  • olives

dairy and egg

  • egg yolk
  • whole egg
  • cream
  • cream cheese
  • goat cheese
  • cheddar cheese
  • Monterey cheese
  • Camembert
  • Muenster cheese
  • Colby cheese
  • brie
  • blue cheese
  • Edam
  • Gruyere
  • parmesan cheese
  • feta cheese
  • mozzarella cheese
  • gouda
  • Provolone
  • Monterey cheese
  • ricotta cheese
  • cottage cheese

animal products & fish

  • polish sausage
  • link sausage
  • chorizo
  • frankfurter
  • bratwurst
  • beef sausage
  • duck
  • knackwurst
  • bacon
  • bologna
  • herring
  • ground lamb
  • chicken
  • chuck eye steak
  • sardines
  • turkey
  • chicken liver
  • anchovy
  • salmon
  • ham
  • carp
  • trout
  • clam
  • catfish
  • shrimp
  • oyster
  • squid
  • lobster
  • cod
  • haddock

vegetables

  • turnip greens
  • mustard greens
  • coriander
  • spinach
  • artichokes
  • mushrooms
  • chives
  • lettuce
  • alfalfa seeds
  • sauerkraut
  • cauliflower
  • asparagus

[this post is part of the insulin index series]

[Like what you’re reading?  Skip to the full story here.]

references

[1] https://www.youtube.com/watch?v=3fM9o72ykww

[2] https://www.youtube.com/watch?v=feyydeMFWy4

[3] https://www.youtube.com/watch?v=KLjgBLwH3Wc

[4] http://www.imdb.com/name/nm0000720/

[5] https://www.youtube.com/watch?v=HyeC9IiFKpw

[6] http://www.charliefoundation.org/

[7] http://www.amazon.com/Keto-Clarity-Definitive-Benefits-Low-Carb/dp/1628600071

14 thoughts on “the therapeutic ketogenic diet”

  1. What if I eliminated three of your categories, nuts …, fruits and veggies, and kept the rest.

    Sent from my iPad 2

    >

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  2. I wrote to Jimmy suggesting he put a bug in the appropriate ear about how and if the keto diet would affect Pica (endless hunger) or Nieman-Pic disease (putting inappropriate things in the mouth). My thinking (as a housewife) is that the hunger-stopping effect of the keto diet may be positive for both problems.

    Thanks for the list above–you made Hubby’s Excel adventure a lot easier!

    Liked by 1 person

  3. Really like how you mentioned the ketogenic diet with so many chronic diseases. Its probable role in reducing ROS (reactive oxygen species), alter gene expression in response to oxidative stress, anti-inflammatory and neural protective functions is what ties all of this together, as so many chronic illnesses share similar cellular dysfunction patterns.

    Liked by 2 people

  4. What is the difference between this food list “The Therapeutic Ketogenic Diet” and the list you have on “Superfoods for Therapeutic Ketosis” page? They do not seem to be identical.

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