Joel Fuhrman, M.D.

[WiseOne]

Yes, the keto diet is the most effective treatment for epilepsy that exists apart from resective brain surgery. It gets a higher response rate than anticonvulsant medications or implanted devices - about 75% response rate compared to 50% or less for these other treatments. It is also used in the ICU for cases of refractory status epilepticus (e.g. in acutely brain injured patients).

Ketogenic diets have also been shown via controlled clinical trials to be effective in several other conditions: type 1 and 2 diabetes, mild/early stage Alzheimer's, cardiovascular risk factors including high blood pressure and triglycerides. There is also lab and anecdotal human evidence that it can be effective against some cancers.

It is frankly shocking to me that it is considered a "fad" diet and is not widely used.

[yankees60]

Yes, the keto diet is the most effective treatment for epilepsy that exists apart from resective brain surgery. It gets a higher response rate than anticonvulsant medications or implanted devices - about 75% response rate compared to 50% or less for these other treatments. It is also used in the ICU for cases of refractory status epilepticus (e.g. in acutely brain injured patients).

Ketogenic diets have also been shown via controlled clinical trials to be effective in several other conditions: type 1 and 2 diabetes, mild/early stage Alzheimer's, cardiovascular risk factors including high blood pressure and triglycerides. There is also lab and anecdotal human evidence that it can be effective against some cancers.

It is frankly shocking to me that it is considered a "fad" diet and is not widely used.

You are the medical expert. And, I may well be classified as the farthest from a medical expert as one can be. Here is what Dr. Fuhrman has written.


Why a Nutritarian Diet is Superior to the Ketogenic Diet in the Fight Against Cancer

https://www.drfuhrman.com/elearning/eat ... nst-cancer

"Although a ketogenic diet does appear helpful for treating drug-resistant epilepsy in children, the anticonvulsant pathway of this high-fat, low-carbohydrate diet remains unclear."

Vinny

[yankees60]

I'm silently pondering which is a better way to end my days on this earth:

1. Eat and drink mostly everything in moderation and die of a heart attack at age 80 (yes, beer, bacon, ice cream and cookies are tasty), or

2. Go on some sort of a wacko 'tasty things restricted' diet (that changes like the seasons depending on who needs cash from selling a new book) and possibly live to 90 or 100 with my last decade or two with Alzheimer's, not knowing who I am when I peer into a mirror gazing at some dude with a Charles Atlas (that dates me ) body with a chinched in belt holding a glass of cabbage juice and munching on a lettuce leaf.

Decisions, decisions, decisions.

One might may an analogy to Pascal's Wager, which I'd be shocked if you were not thoroughly familiar with....

Vinny

"The gist of the Wager is that, according to Pascal, one cannot come to the knowledge of God’s existence through reason alone, so the wise thing to do is to live your life as if God does exist because such a life has everything to gain and nothing to lose. If we live as though God exists, and He does indeed exist, we have gained heaven. If He doesn’t exist, we have lost nothing. If, on the other hand, we live as though God does not exist and He really does exist, we have gained hell and punishment and have lost heaven and bliss. If one weighs the options, clearly the rational choice to live as if God exists is the better of the possible choices. Pascal even suggested that some may not, at the time, have the ability to believe in God. In such a case, one should live as if he had faith anyway. Perhaps living as if one had faith may lead one to actually come to faith."

[dualstow]

I don’t know diets, but Pascal’s Wager has been thoroughly trounced.
https://en.wikipedia.org/wiki/Pascal%27 ... #Criticism

[Kriegsspiel]

Yes, the keto diet is the most effective treatment for epilepsy that exists apart from resective brain surgery. It gets a higher response rate than anticonvulsant medications or implanted devices - about 75% response rate compared to 50% or less for these other treatments. It is also used in the ICU for cases of refractory status epilepticus (e.g. in acutely brain injured patients).

Ketogenic diets have also been shown via controlled clinical trials to be effective in several other conditions: type 1 and 2 diabetes, mild/early stage Alzheimer's, cardiovascular risk factors including high blood pressure and triglycerides. There is also lab and anecdotal human evidence that it can be effective against some cancers.

It is frankly shocking to me that it is considered a "fad" diet and is not widely used.

You are the medical expert. And, I may well be classified as the farthest from a medical expert as one can be.

Why do you think you can determine that he's right, then?

Here is what Dr. Fuhrman has written.

There are two types of ketogenic diets: one consists of high-fat and low carbohydrate; the other is high protein with low carbohydrate.

Meh. I say a diet is ketogenic when ketones can be detected on the piss strips. Although you are probably "in ketosis" on a low fat, low carb diet, ketones might not accumulate to a sufficient level for you to piss hot. On a high fat, low carb diet you will. In addition, his classification don't really mean anything. What makes a diet high fat, medium fat, etc? I suspect he's talking about ratios, but he isn't . If someone eats 300g of fat and 210g of protein a day, is he eating a high fat, low protein diet? 90g and 80g? The words high and low don't really tell you much.

Under normal circumstances, the brain uses glucose exclusively to produce energy. However, when carbohydrates, the supplier of glucose, is insufficient, the body goes into an emergency state, known as ketosis, whereby the brain uses ketones (derived from fat) as an alternative or emergency fuel source. These diets aims to keep the body in chronic ketosis.

Ketosis isn't an "emergency state." Sure sounds scary though!

Also, the things in his Nutritarian bullet points, except beans and berries, can be eaten by someone on a keto diet. Tim Ferriss's Slow Carb diet is pretty much a cyclical keto diet (CKD) with beans.

The traditional high-fat ketogenic diet does have the advantage of limiting animal protein, but it is almost impossible to live on oils, nuts and seeds and animal fat without consuming animal protein along with it.

He's talking about the anti-epileptic variant of the ketogenic diet, where the ratio of fat needs to be kept very high (probably for the reason I mentioned above). If you don't need to keep the protein low due to epilepsy, you can eat meat, but he's trying to make it sound as bad as he can. He really loves beans.

But look, if eating beans, nuts, berries and vegetables what you like doing, more power to you.

[Mark Leavy]

Yes, the keto diet is the most effective treatment for epilepsy that exists apart from resective brain surgery. It gets a higher response rate than anticonvulsant medications or implanted devices - about 75% response rate compared to 50% or less for these other treatments. It is also used in the ICU for cases of refractory status epilepticus (e.g. in acutely brain injured patients).

Ketogenic diets have also been shown via controlled clinical trials to be effective in several other conditions: type 1 and 2 diabetes, mild/early stage Alzheimer's, cardiovascular risk factors including high blood pressure and triglycerides. There is also lab and anecdotal human evidence that it can be effective against some cancers.

It is frankly shocking to me that it is considered a "fad" diet and is not widely used.

I've been mostly low carb, carnivore for about 15 years but recently I've been playing with therapeutic levels of ketones. I do a lot of diet experimenting - and I'm not ready to call this a miracle yet - but... so far I like the results. I have been eating about 3.5 grams of fat for every gram of (protein + carbohydrate) for the last 2 months. Butter, eggs, liver and baking chocolate. Every morning, exactly the same meal, one meal only, about 2800 calories.

So far...
My glucose readings now stay about 75 mg/dl and my ketones are about 2.5 mmol/L.
Waist is going down (from already low). Lifts are going up (from moderate).
Skin issues are just gone.
Vision seems to be better. I've never needed glasses, but I'm not squinting in dim light anymore.

I've always been super healthy but this is the bomb. I plan to keep on this for a year and see what I think after that.

Hey, except for the liver, I'm practically a vegetarian now

Mark

[dualstow]

Baking chocolate and no skin issues — I am envious!

[Kriegsspiel]

Yes, the keto diet is the most effective treatment for epilepsy that exists apart from resective brain surgery. It gets a higher response rate than anticonvulsant medications or implanted devices - about 75% response rate compared to 50% or less for these other treatments. It is also used in the ICU for cases of refractory status epilepticus (e.g. in acutely brain injured patients).

Ketogenic diets have also been shown via controlled clinical trials to be effective in several other conditions: type 1 and 2 diabetes, mild/early stage Alzheimer's, cardiovascular risk factors including high blood pressure and triglycerides. There is also lab and anecdotal human evidence that it can be effective against some cancers.

It is frankly shocking to me that it is considered a "fad" diet and is not widely used.

I have been eating about 3.5 grams of fat for every gram of (protein + carbohydrate) for the last 2 months. Butter, eggs, liver and baking chocolate. Every morning, exactly the same meal, one meal only, about 2800 calories.

So you're eating around 85g of protein?

[WiseOne]

Why a Nutritarian Diet is Superior to the Ketogenic Diet in the Fight Against Cancer

https://www.drfuhrman.com/elearning/eat ... nst-cancer

"Although a ketogenic diet does appear helpful for treating drug-resistant epilepsy in children, the anticonvulsant pathway of this high-fat, low-carbohydrate diet remains unclear."

Vinny

I sense a guy with something to sell you. Be careful if he starts mentioning bridges.

That statement about keto diets for epilepsy is one of the most breathtakingly uniformed string of words on the subject I have ever seen. I sincerely hope actual epilepsy patients aren't being taken in by this shyster.

Just for a start: Keppra is one of the most widely used anticonvulsant medications for a ton of good reasons: can be started immediately at a therapeutic dose, broad spectrum, minimal side effects, almost no interactions with other meds. We have no idea why/how it works. So according to this guy we should immediately stop using it then??

Next up, where is the evidence that his "nutritional diet" (what a ridiculous name) is effective for epilepsy, particularly in comparison to the keto diet? By "evidence" I mean "controlled clinical trial" which would require multiple testing arms and a large N for that head to head comparison. Until he's got that to show, he d****d well better just shut up.

[Mark Leavy]

So you're eating around 85g of protein?

Actually closer to 50 or 60. As I've been lifting for a long time, I didn't expect to be able to recover with so (relatively) little protein, but so far, so good. We'll see if it keeps up. I think the enormous amount of saturated fat and cholesterol I'm eating are helping out.