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]
Thanks for this article. I just started a Keto diet so found it appropriate to my current lifestyle. Though I don’t believe your bottom line is strong enough since you simply stating that the diet is “hard to follow” and food is “notoriously unhealthy” without evidence going deeper into why those “notoriously unhealthy” foods are worse than keeping carbohydrate-heavy food that are addictive and give the body a quick sugar high for energy. I believe “hard to follow” is your opinion only, since acceptable Keto foods are found at all restaurants easily and also all grocery stores. All the foods you mention: “rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water” are all Keto-friendly. Many people have been on a Keto-diet for years. A healthy lifestyle is a healthy mindset change and making right choices – it’s not going to be easy.
^ Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–63. doi:10.1542/peds.102.6.1358. PMID 9832569. https://web.archive.org/web/20040629224858/http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM Lay summary]—JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.
We have solid evidence showing that a ketogenic diet reduces seizures in children, sometimes as effectively as medication. Because of these neuroprotective effects, questions have been raised about the possible benefits for other brain disorders such as Parkinson’s, Alzheimer’s, multiple sclerosis, sleep disorders, autism, and even brain cancer. However, there are no human studies to support recommending ketosis to treat these conditions.

Full disclosure: I have followed a low-carb diet for nearly a decade and find no problem adhering to it. I’ve lost weight and all my cardiovascular biomarkers have improved. Moreover, I’ve studied the science and history behind low-carbohydrate diets, so beyond my personal experience, I bring an evidence-based perspective. (Previously, for 25+ years, I adhered faithfully to a “mostly plants” regimen of fruits, veggies, and whole grains, including my own homemade 7-grain bread, while exercising religiously. Yet during that time my blood lipids were unhealthy, and I never could shake an extra 10-20 pounds.)


While it’s true that low-carb diets do raise the so-called bad LDL-cholesterol in some people, it’s important to note that LDL-C, when influenced by diet, has never been shown to have any effect on cardiovascular risk. Large clinical trials and observational studies show that one’s level of LDL-C and the lowering of LDL-C through diet is not reliably linked to cardiovascular outcomes.21, 22, 23
The past 4 years I was suffering from mild to severe pain all over my body and unrelenting fatigue, sleep disturbances, brain fog, etc. Diagnosed with Sjogren’s Syndrome and Fibromyalgia. Medication included Vicodin, Morphine and a muscle relaxer. I would not take Plaquenall (spelling?), Lyrica or other “biologics”. I was taking a bunch of supplements but nothing was improving.  
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The first modern study of fasting as a treatment for epilepsy was in France in 1911.[12] Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication, potassium bromide, which dulled the mind.[13]
While there is no such thing as a one-size-fits-all diet, diets with varying macronutrient compositions can help in supporting different health goals. The ketogenic diet, with its high fat, low carbohydrate, and moderate protein intake, has been solidly researched for a number of health applications since the 1920s and has been growing in popularity in recent years. Additional science and the potential for the ketogenic diet in various applications is emerging.
The ketogenic diet has been studied in at least 14 rodent animal models of seizures. It is protective in many of these models and has a different protection profile than any known anticonvulsant. Conversely, fenofibrate, not used clinically as an antiepileptic, exhibits experimental anticonvulsant properties in adult rats comparable to the ketogenic diet.[58] This, together with studies showing its efficacy in patients who have failed to achieve seizure control on half a dozen drugs, suggests a unique mechanism of action.[56]
Hi, I'm Amanda. I’ve been cooking primal keto and lactopaleo recipes for over a decade, and have developed recipes for top nutrition coaches and ketogenic meal subscription boxes. I'm the author of Keto Life (a guide) and the best-selling Wicked Good Ketogenic Diet Cookbook (a cookbook). Ever heard the phrase,"never trust a skinny chef"? Well, consider me super trustworthy. I will probably never be "skinny," and that’s OK because I’m not here to teach you how to lose weight, my goal is to provide you with awesome recipes. I absolutely adore the ketogenic lifestyle, and it has helped me overcome a number of health issues. I hope my recipes help you do the same, while eatin’ good!
For both keto and Bulletproof diets, opt for full-fat, grass-fed, raw, and organic dairy to reap the anti-inflammatory benefits of omega-3s and CLA. Dairy is a great source of fat on a ketogenic diet, but be mindful not over-do the protein. Although milk (yep, even raw, full-fat, or goat milk) is too high in lactose sugars, you can stay in ketosis with foods like butter, ghee, and colostrum. Avoid sweetened or low-fat dairy, evaporated or condensed milk, and buttermilk to keep your fat intake high.
This may require a lifestyle change for many families, so we advise families who are interested in the diet to learn more by reading some of our excellent printed resources and to talk to each person who regularly cares for the child to make sure there is agreement to try the diet. We usually encourage an appointment with one of our epileptologists to confirm that the diet is right for your child, and then an appointment with our ketogenic diet team to go over more of the details.
Con: Results can vary depending on how much fluid you drink. By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. The strips don’t show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you’re in ketosis.
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