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 bodybuilders 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.

I have also used a filter using Wilders’ formula to show only foods with 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 prioritise the liberal use of fats and oils and 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 to minimise carbohydrates from vegetables.

People battling chronic illnesses also often have allergies, meaning they further need to refine this list.

Therapeutic ketosis foods

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

How Can I Calculate My Nutrient Intake?

If you’re interested in checking if you’re getting just enough dietary phosphorus, you can check your nutrient profile using our Free 7-Day Nutrient Clarity Challenge.

After a week of tracking your current diet in Cronometer, Nutrient Optimiser will give you a prioritised list of foods and NutriBooster recipes that will help you plug your current nutritional gaps.

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To help you level up your nutrient density, we’ve prepared a Nutritional Optimisation Starter Pack to ensure you are getting plenty of all the essential nutrients from the food you eat every day.

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