The word “ketogenic” comes from a process in our body that occurs when we have low levels of glucose and our liver is breaking down fat for use as energy. Part of the process of breaking down fat creates “ketone bodies” (“ketones” for short). Our organs (including our hearts and brains) can use ketones as fuel.

 If someone has low enough glucose and they begin producing higher levels of ketones, they are said to be in “ketosis.” (A level of 0.5 is considered to be the threshold for nutritional ketosis, but higher levels may be necessary for different therapeutic purposes.)

(This is not to be confused with “ketoacidosis,” a dangerous pathological state that can occur when people with type 1 diabetes have poorly controlled blood sugar.)

There are different levels of what people call ketogenic diets:

• “Doing keto”: For some it has simply become a synonym for a low-carb diet, and those following may or may not be in actual ketosis
• Nutritional ketosis: This level of ketosis is appropriate for weight loss and reversing insulin resistance and metabolic syndrome.
• Therapeutic ketosis: This is a higher level of ketosis used to treat or reverse a whole host of chronic conditions and diseases that have a metabolic component. These should only be done under the direct supervision of a doctor or other medical practitioner.

Here is a partial list of conditions for which a therapeutic ketogenic diet has either been confirmed to be helpful or has shown promise as a treatment:

• Epileptic seizures. Ketogenic diets have been used for over one hundred years to effectively reduce or eliminate epileptic seizures.
• Diabetes (Type 2). Ketogenic diets have been used to treat diabetes, and many have seen their diabetes go into complete remission and have gotten off all their medications.
• Mental health: The medical schools at both Harvard and Standard have launched departments of metabolic psychiatry, where they use metabolic treatments to improve mental health, including the use of ketogenic diets. They have seen remarkable improvements in patients with severe mental health conditions, up to and including complete remission.
• Studies testing whether ketogenic diets improve Alzheimer’s symptoms are ongoing.
• Heart failure: There is emerging evidence that heart function can improve on ketogenic diets.
• Cancer: Ketogenic diets are being used in conjunction with other treatments; in some cases it has been found to reduce the side effects of chemo and other therapies and to make those therapies more effective.
• Migraines: Multiple studies have shown ketogenic dietary therapies can reduce the frequency and intensity of migraines.

I would like to reiterate here that you should not do substantial carbohydrate restriction without letting your doctor know. That is especially true if you are on medications for blood pressure, blood sugar control, or mental health.

One other note: Some people adopting a very low carbohydrate diet find that their LDL cholesterol rises significantly (some others see it go down). Should you find that concerning you can add some carbs back in to bring it down.

If you or someone you know would like to investigate how a therapeutic ketogenic diet can help with a chronic condition, a good place to start is the Charlie Foundation. It began as a resource for parents of children with seizure disorders, and has expanded to include information about how ketogenic diets are being used to treat other chronic conditions, including neurodegenerative diseases and mental health disorders. https://charliefoundation.org.