I have great respect for Harvard Medical School. I notice that they support their readers posting comments and I am most appreciative of the article and all the many thoughtful comments by the readers. The readers seem to have the most expertise here and I hope that the doctor who wrote the article will think long and hard about the comments by readers. After 35 years of clinical practice in mental health, I notice that all issues of emotion involve medical issues, nutrition, and the gut bacteria. I would say that these issues and all of the executive brain functions seem to improve with ketogenic principles. For those that apply it in a flexible and smart manner, it appears to improve every area of their lives. I strongly encourage the author of the article to take one class via The Institute for Functional Medicine. If he is open to more learning he can take more classes and get certified. I’m sure a fine doctor, he will be an even better doctor and personally healthier, if he gets more training. Are we all open to new learning(especially us healthcare providers)?
Carol- so sorry to hear about your stroke. I am not sure most doctors would approve of this diet due to most not being taught much on nutrition in med school, and most still believe in the old school high carb low fat way of eating. My experience has been a dramatic drop in my blood pressure in only a few weeks after starting this diet (172/105 down to 144/95!). I suggest giving it a trial of a few months to see how it may work for you.

Because some cancer cells are inefficient in processing ketone bodies for energy, the ketogenic diet has also been suggested as a treatment for cancer.[58][59] A 2018 review looked at the evidence from preclinical and clinical studies of ketogenic diets in cancer therapy. The clinical studies in humans are typically very small, with some providing weak evidence for anti-tumour effect, particularly for glioblastoma, but in other cancers and studies, no anti-tumour effect was seen. Taken together, results from preclinical studies, albeit sometimes contradictory, tend to support an anti-tumor effect rather than a pro-tumor effect of the KD for most solid cancers.[60]
You've likely heard horror stories of what competitors feel like when they cut carbs low, or when the average bro talks about going keto. However, the odds are that those people were not actually in nutritional ketosis, or more importantly, following a well-formulated ketogenic diet. Yes, you may experience some fogginess and discomfort, but it doesn't have to be intense if you handle it right.
The ketogenic diet for weight loss is based on the idea that driving the body into ketosis will maximize fat loss. Ketosis is a normal metabolic process that occurs when the body does not have enough glucose stores for energy. When these stores are depleted, the body resorts to burning stored fat for energy instead of carbs.  This process produces acids called ketones, which build up in the body and can be used for energy. (2)

.. it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. What is unhealthy about red meat. We should know that acrilamides, pyrroles in burnt meat (and veges) from BBQ and over-heated cooking inflames the colon. According to Clark H R, PhD ND an inflamed part allows easy entry for the cancer nucleus and cancer complex, to start and fuel a malignancy at that location.


In Asia, the normal diet includes rice and noodles as the main energy source, making their elimination difficult. Therefore, the MCT-oil form of the diet, which allows more carbohydrate, has proved useful. In India, religious beliefs commonly affect the diet: some patients are vegetarians, will not eat root vegetables or avoid beef. The Indian ketogenic diet is started without a fast due to cultural opposition towards fasting in children. The low-fat, high-carbohydrate nature of the normal Indian and Asian diet means that their ketogenic diets typically have a lower ketogenic ratio (1:1) than in America and Europe. However, they appear to be just as effective.[53]
Following a diet that drastically restricts carbohydrates requires carefully monitoring your food choices to ensure you are meeting your nutritional needs. Working together with a registered dietitian can make sure you follow this diet in a healthy manner without increasing your risk for complications or negative side effects. You can find a registered dietitian at EatRight.org.
If you need to eat more or fewer calories per day, you can adjust accordingly by simply taking out or adding a bit more of the ingredients already included in a recipe. For example, adding/removing a tablespoon of olive oil or butter will add/remove about 100 calories. If you like or dislike certain recipes, feel free to shift things around. Make sure to keep an eye on the calories so you’re still falling within an acceptable range of your daily goal.
According to Macri, “If somebody is looking for physical and psychological health, the best way to get there is to focus on health. That entails eating in balance, not restrictively; moving regularly; and looking at the role of stress in one’s life. Those three areas will get someone to health as well as happiness.” Check out the 13 things doctors want you to know about the keto diet.

Aude, Y., A. S, Agatston, F. Lopez-Jimenez, et al. “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat: A Randomized Trial.” JAMA Internal Medicine 164, no. 19 (2004): 2141–46. doi: 10.1001/archinte.164.19.2141. jamanetwork.com/journals/jamainternalmedicine/article-abstract/217514.
This means that to achieve ketosis, you have to limit your carb intake to less than 50 grams per day (most people should reach ketosis within a week of following the diet). To put this in perspective, the low-carb diet you’re most familiar with—the Atkins Diet—recommends about 130 grams of carbs per day. Also for reference, one bagel has about 55 grams of carbs.
And although in the short term, ketogenic diets seem safe for healthy people, we also lack long-term data on the diet, so it’s hard to confirm long-term safety with certainty. Complications seen with kids maintaining a ketogenic diet for epilepsy, for example, included kidney stones, constipation, gastrointestinal issues, pancreatitis, and vitamin D and calcium deficiencies.
If you need to eat more or fewer calories per day, you can adjust accordingly by simply taking out or adding a bit more of the ingredients already included in a recipe. For example, adding/removing a tablespoon of olive oil or butter will add/remove about 100 calories. If you like or dislike certain recipes, feel free to shift things around. Make sure to keep an eye on the calories so you’re still falling within an acceptable range of your daily goal.
Early studies reported high success rates: in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (what is known as a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).[18]

For patients who benefit, half achieve a seizure reduction within five days (if the diet starts with an initial fast of one to two days), three-quarters achieve a reduction within two weeks, and 90% achieve a reduction within 23 days. If the diet does not begin with a fast, the time for half of the patients to achieve an improvement is longer (two weeks) but the long-term seizure reduction rates are unaffected.[43] Parents are encouraged to persist with the diet for at least three months before any final consideration is made regarding efficacy.[9]
When a person goes off the ketogenic diet and regains much of their original weight, it’s often not in the same proportions, says Kizer: Instead of regaining lean muscle, you’re likely to regain fat. “Now you’re back to your starting weight, but you no longer have the muscle mass to burn the calories that you did before,” she says. “That can have lasting effects on your resting metabolic rate, and on your weight long-term.”
"It was extremely difficult," he recalls. "You spend your entire life hearing that fat makes you fat and causes heart attacks and strokes. Now, all of a sudden, you're eating 200 grams of fat per day. There is a huge psychological component to conquer before you can become successful with the keto diet. In the beginning, it's like trying to convince people 1,000 years ago that the world is in fact round, not flat."
For patients who benefit, half achieve a seizure reduction within five days (if the diet starts with an initial fast of one to two days), three-quarters achieve a reduction within two weeks, and 90% achieve a reduction within 23 days. If the diet does not begin with a fast, the time for half of the patients to achieve an improvement is longer (two weeks) but the long-term seizure reduction rates are unaffected.[43] Parents are encouraged to persist with the diet for at least three months before any final consideration is made regarding efficacy.[9]
Net carbs are what we track when following a ketogenic diet. This calculation is pretty straightforward. Net Carbs = Total Carbs – Fiber. For example, one cup of broccoli has 6g of total carbs and 2.4g of fiber. That would mean one cup of broccoli has 3.6g of net carbs. We count Net Carbs  because dietary fiber does not have a significant metabolic effect. 
If you’ve decided to move forward in trying the keto diet, you will want to stick to the parameters of the eating plan. Roughly 60 to 80 percent of your calories will come from fats. That means you’ll eat meats, fats, and oils, and a very limited amount of nonstarchy vegetables, she says. (This is different from a traditional low-carb diet, as even fewer carbs are allowed on the keto diet.)
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