The most successful ketogenic diet that I have seen in the literature was used in children, and produced long-term survival (4-10 years) in pediatric high-grade brain cancer patients. (1) Until more evidence in the literature emerges, it is my judgment that this is the version of the diet that will likely yield the best results.
The diet should consist of 60% of fat calories coming from MCT (medium chain triglyceride) oil, 20% other fats, 10% protein, and 10% carbohydrate.
This sample diet will give you the correct proportion of calories from fat, protein, and carbohydrate. Follow it for six weeks. I have specifically designed it to minimize nutrient deficiencies.
Rotate daily between the meats listed above to maintain proper vitamin and mineral status. This is very important because you will initially be limiting calories!
Ordinary muscle meats are much less nutritious. If you must eat ordinary muscle meats, please supplement with 1 tsp. cod liver oil per day in order to get adequate vitamins, minerals, and omega 3 fatty acids.
As a rule, the ketogenic diet will come up low in potassium, magnesium, and vitamin D. It is therefore important to supplement roughly 1500 mg. potassium, 150 mg. magnesium, and 2000-5000 units of Vitamin D3 daily, as written above.
Monitor Your Progress
It is easy and important to enter what you eat into a free internet program, FitDay.com, in order to keep track of daily calories, vitamins, minerals, and ratios of calories from fat, protein, and carbohydrate.
Again, the basic principle is to keep calories at around 80%, protein at around 10%, and carbohydrate at around 10%.
The work does not stop by simply eating the above diet! Thomas Seyfried, a prolific researcher with regard to the ketogenic diet, believes that a certain ratio of blood glucose to ketones is required for the diet to be effective against cancer (2-4). Thankfully, blood monitoring tools are available for you to be able to accomplish this easily at home.
Your goal should be to get your blood glucose down to around 70 mg/dl or lower, and to achieve blood ketone levels of between 3 to 8 mM (2-4).
However, it’s the ratio of these two values that is believed by researchers to be most important. It sounds complicated, but don’t worry. It’s easy!
First, test your blood glucose according to meter instructions and record here: ________ mg/dL
Second, take that value of blood glucose above and divide it by 18. For example, if your blood glucose is 90 mg/dL, the mM value will be 5.
Record that value here: blood glucose _______ mM (A)
Third, test your blood ketones according to meter instructions and record here: ________ mM (B)
Fourth, divide glucose (A, in mM) by ketones (B, in mM). Record here: ________ (C)
For example, if your blood glucose is 4mM, and your blood ketones are 4mM, that is a ratio of 1.0 for (C), which is perfect.
You want to aim for that final ratio in space C to be 1.0 or less, on a daily basis.
It will probably take a week for your body to adjust to the new diet and actually start lowering glucose and raising ketones. If you can’t achieve low enough levels of blood glucose and high enough levels of ketones, you can try several things:
I recommend against trying all of these measures at once, however. Do not make drastic changes to a successful program.
It’s very important to keep protein and carbohydrate limited:
It is also very important to keep measuring your blood glucose and ketones on a daily basis to make sure they stay in target range, with a ratio of 1.0 blood glucose (mM) to blood ketones (mM).
If you decide to try the ketogenic diet, keep on top of monitoring the cancer with medical imaging scans or blood tests, and be prepared to change course if necessary.
Preliminary lab studies indicate that low glucose levels can drive mutations that can actually cause an increase of the glucose transporter in tumor cells. What this means is that the cancer could eventually become resistant to a ketogenic diet or adapt to the use of ketones for fuel (6, 7).
If your cancer fails to slow down in its growth or if its growth accelerates, be prepared to change course, and look into the Gerson Diet.
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The following items may or may not be needed depending on one's specific adherence to various parts of the diet above:
(1) Nebeling LC, Miraldi F, Shurin SB, Lerner E. 1995. Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: two case reports. Am Coll Nutr. 14(2):202-8. doi: 10.1080/07315724.1995.10718495
(2) Schwartz K, Chang HT, Nikolai M, Pernicone J, Rhee S, Olson K, Kurniali PC, Hord NG, Noel M. 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 Metab. 3: 3. doi: 10.1186/s40170-015-0129-1
(3) Meidenbauer JJ, Mukherjee P, Seyfried TN. 2015. The glucose ketone index calculator: a simple tool to monitor therapeutic efficacy for metabolic management of brain cancer. Nutr Metab (Lond). 12: 12. doi: 10.1186/s12986-015-0009-2
(4) Seyfried T, Kibosh M, Marsh J, Mukherjee P. 2009. Targeting energy metabolism in brain cancer through calorie restriction and the ketogenic diet. Journal of Cancer Research and Therapeutics. 5(9): 7-15.
(5) Klement RJ, Champ CE. 2014. Calories, carbohydrates, and cancer therapy with radiation: exploiting the five R’s through dietary manipulation. Cancer Metastasis Rev. 33(1): 217–229. doi: 10.1007/s10555-014-9495-3
(6) Yun J, Rago C, Chiong I, Pagliarini R, Angenendt P, Rajagopalan H, Schmidt K, Willson JKV, Markowitz S, Zhou S, Diaz LA Jr, Velculescu VE, Lengauer C, Kinzler KW, Vogelstein B, Papadopoulos N. 2009. Glucose Deprivation Contributes to the Development of KRAS Pathway Mutations in Tumor Cells. Science 1325: 1555-1559. DOI: 10.1126/science.1174229
(7) Saraon P, Cretu D, Musrap N, Karagiannis GS, Batruch I, Drabovich AP, van der Kwast T, Mizokami A,Morrissey C, Jarvi K, Diamandis EP. 2013. Quantitative Proteomics Reveals That Enzymes of the Ketogenic Pathway Are Associated with Prostate Cancer Progression. Mol Cell Proteomics. 12(6): 1589–1601. doi: 10.1074/mcp.M112.023887
The ideas in this website are not intended as a substitute for the advice of a trained health professional. All matters regarding your health require medical supervision. Consult your physician and/or health care professional before adopting any nutritional, exercise, or medical protocol. Consult your physician about any condition that may require diagnosis or medical attention. Statements regarding certain products and services represent the views of the author alone, and do not constitute a recommendation or endorsement or any product or service.