It’s hard not to be enthusiastic about what the future holds for the ketogenic diet. It’s already shown itself to be massively more helpful in certain conditions than the most state-of-the-art pharmaceuticals, with none of the significant and unpredictable drawbacks of drugs.
And this is only just the beginning. The floodgates to research on the ketogenic diet have opened, and it seems every day we’re learning about some new potential applications.
With that in mind, here’s a short overview of some of the areas in health (beyond migraines and epilepsy, which are covered in the book) where the ketogenic diet is showing great promise as a therapeutic tool.
It’s long been known that many cancer cells require glucose to survive. Depriving those cells of dietary glucose with a ketogenic diet is a way of selectively killing off the cancerous cells (unlike chemotherapy, which kills cells indiscriminately). Though not limited to this area, the ketogenic has shown particular promise in treating brain cancer.
“Starving Cancer” TEDx Talk by Dom D’Agostino
SELECTED PUBLICATIONS on the Ketogenic Diet for Cancer
Weber, Daniela D., Sepideh Aminazdeh-Gohari, and Barbara Kofler. 2018. “Ketogenic Diet in Cancer Therapy.” Aging 10 (2): 164–65.
Zhou, Weihua, Purna Mukherjee, Michael A. Kiebish, William T. Markis, John G. Mantis, and Thomas N. Seyfried. 2007. “The Calorically Restricted Ketogenic Diet, an Effective Alternative Therapy for Malignant Brain Cancer.” Nutrition & Metabolism 4 (February): 5.
Schwartz, Kenneth, Howard T. Chang, Michele Nikolai, Joseph Pernicone, Sherman Rhee, Karl Olson, Peter C. Kurniali, Norman G. Hord, and Mary Noel. 2015. “Treatment of Glioma Patients with Ketogenic Diets: Report of Two Cases Treated with an IRB-Approved Energy-Restricted Ketogenic Diet Protocol and Review of the Literature.” Cancer & Metabolism 3 (March): 3.
Poff, Angela M., Csilla Ari, Thomas N. Seyfried, and Dominic P. D’Agostino. 2013. “The Ketogenic Diet and Hyperbaric Oxygen Therapy Prolong Survival in Mice with Systemic Metastatic Cancer.” PloS One 8 (6): e65522.
Rossi-Fanelli, F., F. Franchi, M. Mulieri, C. Cangiano, A. Cascino, F. Ceci, M. Muscaritoli, P. Seminara, and L. Bonomo. 1991. “Effect of Energy Substrate Manipulation on Tumour Cell Proliferation in Parenterally Fed Cancer Patients.” Clinical Nutrition 10 (4): 228–32.
Martuscello, Regina T., Vinata Vedam-Mai, David J. McCarthy, Michael E. Schmoll, Musa A. Jundi, Christopher D. Louviere, Benjamin G. Griffith, et al. 2016. “A Supplemented High-Fat Low-Carbohydrate Diet for the Treatment of Glioblastoma.” Clinical Cancer Research: An Official Journal of the American Association for Cancer Research 22 (10): 2482–95.
Type 2 diabetes has reached epidemic proportions and is a disease that is a direct consequence of our modern high carbohydrate diet. The signature problem of type 2 diabetes is that the cells develop resistance to the effects of insulin, resulting in toxic levels of glucose in the blood and widespread organ damage.
A ketogenic diet not only provides an alternative, non-toxic fuel source but has even been shown to reverse the disease altogether. In a study of the ketogenic diet for diabetes performed by Virta Health, 68% of study subjects were able to stop all diabetes medications after one year, and 55% of those who remained on a ketogenic diet for 2 years reversed their diabetes entirely.
Just like migraine, diabetes was once thought to be a chronic and lifelong condition. The only real options then were drugs that could hopefully mitigate their options. Results like this from a ketogenic diet weren’t supposed to be possible. And yet….
Ketogenic Diet for Diabetes with Sarah Hallberg, DO
SELECTED PUBLICATIONS on the Ketogenic Diet for Diabetes
Hallberg, Sarah J., Amy L. McKenzie, Paul T. Williams, Nasir H. Bhanpuri, Anne L. Peters, Wayne W. Campbell, Tamara L. Hazbun, et al. 2018. “Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study.” Diabetes Therapy: Research, Treatment and Education of Diabetes and Related Disorders 9 (2): 583–612.
Given the known neurophysiological similarities amongst seizures, migraines, and bipolar disorder, and given that ketones exert special effects on the brain, it’s perhaps no surprise that it improves psychological well being. Research remains very early, but practitioners all over are employing a ketogenic. Just like with migraines and diabetes, delivering results far better than anything else, and allowing them to come off of unpleasant drugs they’d been on for years or decades.
Areas where it is being investigated and used include anxiety disorders, major depression, bipolar, and autism spectrum disorders.
SELECTED PUBLICATIONS on the Ketogenic Diet for Mental Health
Verpeut, Jessica L., Emanuel DiCicco-Bloom, and Nicholas T. Bello. 2016. “Ketogenic Diet Exposure during the Juvenile Period Increases Social Behaviors and Forebrain Neural Activation in Adult Engrailed 2 Null Mice.” Physiology & Behavior 161 (July): 90–98.
Georgia, Ede. 2017. “Ketogenic Diets for Psychiatric Disorders: A New Review.” Psychology Today, June 30, 2017. https://www.psychologytoday.com/blog/diagnosis-diet/201706/ketogenic-diets-psychiatric-disorders-new-review
ALZHEIMER’S & PARKINSON’S
Virtually every chronic disease affecting the brain may benefit from a ketogenic diet – Alzheimer’s and Parkinson’s happen to be the most common and widely researched.
As I’ve mentioned, I already consider periodically adopting a ketogenic diet to be fundamental to preventing chronic disease of the brain. But there is now a growing body of evidence that nutritional ketosis can halt or even reverse the progression of neurodegenerative diseases like Alzheimer’s and Parkinson’s. For obvious reasons, this is an area of intense interest, one you’re guaranteed to hear much more about in the coming years.
SELECTED PUBLICATIONS on the Ketogenic Diet for Neurodegenerative Disorders
Stafstrom, Carl E., and Jong M. Rho. 2012. “The Ketogenic Diet as a Treatment Paradigm for Diverse Neurological Disorders.” Frontiers in Pharmacology 3 (April): 59.
Paoli, Antonio, Antonino Bianco, Ernesto Damiani, and Gerardo Bosco. 2014. “Ketogenic Diet in Neuromuscular and Neurodegenerative Diseases.” BioMed Research International 2014 (July): 474296.
Krikorian, Robert, Marcelle D. Shidler, Krista Dangelo, Sarah C. Couch, Stephen C. Benoit, and Deborah J. Clegg. 2012. “Dietary Ketosis Enhances Memory in Mild Cognitive Impairment.” Neurobiology of Aging 33 (2): 425.e19–27.
Reger, Mark A., Samuel T. Henderson, Cathy Hale, Brenna Cholerton, Laura D. Baker, G. S. Watson, Karen Hyde, Darla Chapman, and Suzanne Craft. 2004. “Effects of Beta-Hydroxybutyrate on Cognition in Memory-Impaired Adults.” Neurobiology of Aging 25 (3): 311–14.
Rusek, Marta, Ryszard Pluta, Marzena Ułamek-Kozioł, and Stanisław J. Czuczwar. 2019. “Ketogenic Diet in Alzheimer’s Disease.” International Journal of Molecular Sciences 20 (16). https://doi.org/10.3390/ijms20163892.
Gasior, Maciej, Michael A. Rogawski, and Adam L. Hartman. 2006. “Neuroprotective and Disease-Modifying Effects of the Ketogenic Diet.” Behavioural Pharmacology 17 (5-6): 431–39.
AUTOIMMUNE & INFLAMMATORY DISEASE
The ketogenic reduces inflammation in multiple ways both direct and indirect. Even viewed conservatively, this means it could be transformative for autoimmune conditions where the immune system attacks parts of the body.
But, when we consider that inflammation is a signature of virtually every chronic disease of our time, then it becomes plausible to consider that there’s virtually no condition that it would not benefit.
SELECTED PUBLICATIONS on the Ketogenic Diet for Autoimmune & Inflammatory Disorders
Pinto, Alessandro, Alessio Bonucci, Elisa Maggi, Mariangela Corsi, and Rita Businaro. 2018. “Anti-Oxidant and Anti-Inflammatory Activity of Ketogenic Diet: New Perspectives for Neuroprotection in Alzheimer’s Disease.” Antioxidants (Basel, Switzerland) 7 (5). https://doi.org/10.3390/antiox7050063.
Masino, Susan A., and David N. Ruskin. 2013. “Ketogenic Diets and Pain.” Journal of Child Neurology 28 (8): 993–1001.
Shen, Yiguo, David Kapfhamer, Angela M. Minnella, Ji-Eun Kim, Seok Joon Won, Yanting Chen, Yong Huang, Ley Hian Low, Stephen M. Massa, and Raymond A. Swanson. 2017. “Bioenergetic State Regulates Innate Inflammatory Responses through the Transcriptional Co-Repressor CtBP.” Nature Communications 8 (1): 624.
Nandivada, Prathima, Gillian L. Fell, Amy H. Pan, Vania Nose, Pei-Ra Ling, Bruce R. Bistrian, and Mark Puder. 2016. “Eucaloric Ketogenic Diet Reduces Hypoglycemia and Inflammation in Mice with Endotoxemia.” Lipids 51 (6): 703–14.
Youm, Yun-Hee, Kim Y. Nguyen, Ryan W. Grant, Emily L. Goldberg, Monica Bodogai, Dongin Kim, Dominic D’Agostino, et al. 2015. “The Ketone Metabolite β-Hydroxybutyrate Blocks NLRP3 Inflammasome-Mediated Inflammatory Disease.” Nature Medicine 21 (3): 263–69.
MENTAL & PHYSICAL PERFORMANCE
Those who push their brains and bodies to the height of performance are always looking for a competitive edge, which the ketogenic diet clearly offers. In fact, it’s popularity has been accelerated by many high-profile athletes across a range of sports who are using a ketogenic diet to both improve their athletic performance and resilience,so that they’re able to perform better for longer.
Ketogenic Diet and Endurance in Athletes by Jeff Volek, PhD
SELECTED PUBLICATIONS on the Ketogenic Diet for Athletic Performance
McSwiney, Fionn T., Bruce Wardrop, Parker N. Hyde, Richard A. Lafountain, Jeff S. Volek, and Lorna Doyle. 2018. “Keto-Adaptation Enhances Exercise Performance and Body Composition Responses to Training in Endurance Athletes.” Metabolism: Clinical and Experimental 81 (April): 25–34.
Zajac, Adam, Stanisław Poprzecki, Adam Maszczyk, Miłosz Czuba, Małgorzata Michalczyk, and Grzegorz Zydek. 2014. “The Effects of a Ketogenic Diet on Exercise Metabolism and Physical Performance in off-Road Cyclists.” Nutrients 6 (7): 2493–2508.
Even this cursory overview demonstrates that essentially every major category of illness appears to benefit from a ketogenic diet. And you can be sure that in the coming years, this list will continue to grow, as well our understanding of how to best use nutritional ketosis as a therapeutic tool.