Ketosis for Cancer: Week 1—My Transition to Ketosis

number 1A Bumpy Transition to Ketosis

Fasting for more than 36 hours proved challenging in ways that took me completely by surprise so I decided to break my fast on Day 4 and continue my transition to ketosis while eating food. My goal remains to reach Prof. Seyfried’s recommended “zone of metabolic management”: blood glucose between 55 and 65 mg/dL and blood ketone levels of at least 4.0 mM. How much protein should I eat to try to get there? How many calories?

Note: this post was originally published on Aug 1, 2013. It was edited to streamline content and improve graphics, then re-posted in June 2016, therefore some older comments may pertain to content that was removed during revision.

This post is part of a series describing my attempt to follow Dr. Seyfried’s dietary recommendations for cancer. To see what happened on Days 1-3, please go to the first post: Seyfried’s Ketogenic Cancer Diet: My Fasting Jump-Start to Ketosis.

A funny thing happened on the way to ketosis…

Day 4 (2/3/13)—fourth day of fasting

transition to ketosis Day 4 am stats

Notes: Only slept from 2 am to 5:30 am. Big jump in ketones this morning, but hungrier. Numerous unhappy symptoms: difficulty concentrating, tired but couldn’t sleep, mild headache, low energy, a little cold, heartbeat a little stronger than usual, dark circles under eyes, stomach growly, and slight tinnitus (ringing in the ears). At this point, I considered breaking the fast, but then something happened that convinced me it was time to eat.

harpMy cell phone rang at about 2 pm [my ringtone is a harp playing a lovely arpeggio; you may be familiar with it]. Anyway, I answered the call, spoke for a few minutes, and then hung up. But the harp kept playing, very faintly and mysteriously, in the distance, nowhere near where my phone was located…over and over again. Uh-oh. I realized that I must be having a mild auditory hallucination—certainly something I had never experienced before in my whole life. While absolutely fascinating to me on one level, it was a clear indication that my brain was not getting the nutrients it needed to function properly, so quite concerning on another level.

This hauntingly beautiful harp call was either a sign that my ascension was drawing nigh, or it was time to have some lunch. I chose lunch:)

What does this mean for cancer patients?

What does this mean for people with cancer who may have been considering fasting up to 5 days to rapidly establish ketone levels of 4.0 mM? It may mean nothing. It may be my own unique response to fasting. Perhaps some people tolerate fasting for more than 3 days beautifully. However, at least for me, fasting for longer than 3 days was not tolerable, and to have continued the fast would have been unwise.

SodaStream (Soda-Club) USA

Now, if I had continued another day or two until my ketones had risen to 4.0 mM, would all of the side effects have gone away? I don’t know. If I had already been keto-adapted (at lower ketone levels), would I have tolerated the fast better? Maybe, I don’t know. But since the point of the fast is to change from a regular diet to ketosisk as rapidly as possible, people who try this plan aren’t expected to be keto-adapted already. In most cases, I think it may be wiser to try Dr. Seyfried’s alternative initiation plan instead of fasting (see details in the Dietary Treatment of Cancer post).

I certainly could never have accomplished his recommendation of an annual 7-day fast, so my cells will not have the opportunity to cannibalize each other after all. I am just going to have to hope that my healthy diet naturally reduces my risk for developing pre-cancerous cells in the first place.

The transition to a ketogenic diet

What’s next? I will continue to try to reach Seyfried’s “zone of metabolic management” while eating a carefully measured, mostly meat, ketogenic diet.

First, I need to calculate my protein requirements. Based on my personal stats:

  • Dr. Seyfried recommends I eat between 62 and 92 grams of protein per day.
  • Phinney and Volek recommend I eat between 75 and 156 grams of protein per day.
  • Dr. Rosedale recommends I eat 77 grams of protein per day based on my body measurements, but 47 grams of protein per day based on my body fat percentage.

Hmmmm… since protein requirements are clearly difficult to estimate (see my protein page for more details), and one size does not fit all, I’m just going to start with 75 grams of protein per day, and if I need to adjust it along the way, I will.

If I were trying to treat cancer, Dr. Seyfried would want me to reduce my calorie intake significantly below my daily requirements (resting/basal metabolic rate or “BMR”). My estimated BMR is 1400 cals/day, so I’ll try to keep my calories to a maximum of 1400 per day.

Day 4, continued:

Transitioning to a ketogenic diet-Day 4

Notes: I felt much better about an hour after eating some food. It was especially wonderful to regain my powers of concentration. And surprisingly, despite having not eaten a thing for nearly 4 days, once I started eating, my appetite was actually fairly low. Therefore my calories for the day were also pretty low. Was this the effect of high ketone levels/low insulin levels?

Day 5 (2/4/13)

Transition Day 5 stats
Notes: Got very hungry at dinnertime but a very small amount of food was required to feel better (8 g protein + 13 g fat).

Day 6 (2/5/13)

Transition Day 6 stats

Day 7 (2/6/13)

Transition Day 7 stats

Reflections on my Transition to Ketosis, Week 1

  • Fasting certainly does jump-start ketosis, but fasting for more than 36 hours may not be safe for everyone, and was no fun.
  • Appetite is generally much lower as ketones rise.
  • Hunger feels different in ketosis than on a standard diet. I experienced mild headache, stomach growls, calm thoughts of food, can still go hours without eating and function fine. Zero emotional component. Compare this to hunger on a standard diet, which (for me) = irritability, anxiety, distractibility, emotional longing for food, sense of urgency, carbohydrate cravings, and wish to stop whatever I’m doing and find something to eat right away.
  • My blood sugar is still pretty high despite high ketones, but I think all bets are off during first few weeks, as “keto-adaptation” can take 3 weeks or more. [Keto-adaptation refers to the body’s adjustment to the efficient use of ketones for fuel instead of glucose.]
  • Do I need to eat more fat to get higher ketones, or is it just a matter of time?  If I were to eat more fat, that would mean more calories—would weight loss slow down or stop?
  • I am hesitant to do any experiments within my experiment until after a month of this plan, so for now I’m going to stick with: 75 g protein, 1400 cals max, carbs less than 30 g/day, mostly meat, no dairy, no caffeine, no artificial anything.

Check out Ketosis for Cancer: Week 2—Protein and Ketosis to see how I got my ketones way, way up.

Recommended Ketogenic Diet and Cancer Resources

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  • Charles Grashow

    I don’t understand the rationale behind this n=1 experiment. You said “I don’t tolerate beef, pork, or avocado very well, can’t eat coconut oil or nuts of any kind, can’t eat eggs or shellfish, and most dairy products do not agree with me.”

    SO – you have a very good idea of what you can’t eat and an idea of appx how many calories you need per day – why not just construct a diet around the foods you CAN eat and stop worrying.

  • Trina

    Dr. Ede, your posts fascinate me! Thank you for this detailed description of your eating journey. I’m on my own journey and am discovering it’s not so black and white for some of us. I love people like Dr. Eenfeldt too but the comments about calories being irrelevant is bothersome. I too have been battling this since childhood. I remember in college not understanding how all my thin friends could eat whatever they wanted and be so thin. I had to watch everything and exercise quite a bit. I’ve lost 47 pounds on a low carb diet (since Jan ’12) but am hitting that proverbial “low carb wall”. The lower I get my carbs the
    worse I seem to feel. This last week I’ve kept them <20 net grams and I cannot fall asleep. Once I do I'm wide awake at 4 am with a hard heart beat. I feel "heavy headed" and am having a hard time focusing. I'm discouraged by these latest symptoms. I have an appointment Monday with a naturopath to at least investigate thyroid and hormone issues. I sure wish it was easier. Anyway, thanks for the great post! I look forward to your updates.

    • Trina

      Sorry for the double post – you may want to delete this one 🙂

    • Hi Trina
      Thank you for sharing your personal experience and congratulations on your 47 lb weight loss! I forgot to mention that there was one low-carb diet that I felt lousy on–the standard Atkins diet, which I tried over 10 yrs ago. I was tired all the time and couldn’t lose weight. For me the key was not just to keep carbs low, but to figure out which foods I was eating more of to replace the carbs–things like high-fat dairy, artificial sweeteners, nuts, etc–it turned out (for me) that it was the presence of these things rather than the absence of carbs that was making me feel bad. I have also learned (only in the past year) that overeating protein can make me feel bad, too. It was more subtle, but sleepiness and stalled weight loss were the two most prominent issues. Everyone is different…I hope that your medical tests are normal, and that you will be able to figure out how to make whatever changes you need to make to feel better and continue your excellent progress.

      • Trina

        Just wanted to upate this comment. After following advice from Paul Jaminet to add back some starch to my diet (according to him my symptoms were classic glucose deficiency) I am starting to bounce back. I am sleeping better and feeling less “ill” overall. I have a ways to go to feel optimal again but so far
        I’m thrilled to be turning this situation around. Time will tell what adding these “safe starches” will do but for now I’m thrilled. I am now reading his book and will try implementing his theories on healthy diet and see where that takes me.

        • Maria

          Trina, it would still be important to have your thyroid checked. If adding carbs makes you feel better, there was most likely a thyroid issue prior to eating low carb but is was subclinical. Adding carbs does not mean that this got fixed on deeper level. You just put a bandaid on it. There is no such thing as glucose deficiency. Only poor energy metabolism and again, fixing it by adding carbs may not be the answer long term.

          • Trina

            Thank you Maria I plan to have it checked. Can I ask how you know there is no such thing? I know Dr. Rosedale believes there isn’t but just curious what the actual evidence is? Seems to me this all part of the Jaminet vs. Rosedale debate. I listened to Dr. Mercola with Dr. Jaminet last night and Dr. Mercola said Jaminet has swayed him to believe that one can go too low on glucose intake (Dr. Mercola did that himself and suffered the consequences). I know Stefani Ruper has discussed this as well.

          • Maria

            Because your brain is the only organ that needs sugar and your liver can make the glucose needed for that through gluconeogenesis. Of course, this assumes a properly functioning liver and cholesterol metabolism. But yeah it is all part of a debate 😉 I personally prefer Nora Gedgaudas’ writing about this in Primal Body Primal Mind.

          • Trina

            Jaminet’s point is that glucose is very important in the body in many more uses than the brain. “According to Dr. Jaminet, it is not common, but possible, to have a deficiency of dietary glucose that could have a detrimental effect on your immune system. About half of your proteins use glucose to work, and they require glucose as a functional element. Additionally, although low-carb diets normally improve blood lipids, extremely low-carb diets can paradoxically increase LDL and triglyceride levels.”

          • Maria

            I believe he is mistake in this.

          • I just read the section oin the Jaminet’s Perfect Health Diet book on “the dangers of glucose deficiency” (pages 32 and 33). They cite zero scientific references to support their beliefs about this phenomenon. Of course this does not mean their theory isn’t true, I just find it unfortunate that such a bold claim, stated so authoritatively, should be so completely unsubstantiated. So, each person will have to rely on his/her own dietary experiences to determine whether or not this hypothesis is true for him/her or not.

  • Henrik

    Dear Georgia,

    You might want to try a variant where you eat between 6 AM and 2 PM, as much as you like. I read an article where some scientist feed rats with equal amounts of food. But one group was feed only during 8 hours. They lost significantly more weight than the other group. The theory behind the experiment was that the rats would go inte ketosis during the intermitent fasting.

    We eat a paleolithic diet since 5 years ago. When my wife gave birth to our 3:d baby she gained about 6 kg which she couldn’t get rid of. Even if she excerciced 5 days a week. She has held on to these 6 kg until 2 month ago. She started to eat breakfast, lunch and a snack between 6AM and 2 PM. Then she only drank water and tea fom 2 PM until 6 AM. After about a week and a half she started to loss weight. She stayed on the diet for 3 weeks and lost about 4 kg. She then held up during the weekends. She gained but then she started to loss weight again. She has now lost 6 kg and are mainteaining her weight on a normal eating schedule.

    Br Henrik

    • Hi Henrik
      Thank you for sharing your wife’s story. Do you happen to know if she was eating about the same amount of calories with the 6-2 plan as she had been eating all day? Do you know if she was in ketosis at night? Once I have been in ketosis for a month, I may try various experiments, including your food timing suggestion. Thank you.

  • Trina

    Dr. Ede, your posts fascinate me! Thank you for this detailed description of your eating
    journey. I’m on my own journey and am discovering it’s not so black and white for some of us. I love people like Dr. Eenfeldt too but the comments about calories being irrelevant is bothersome (and then Drs. Eades say they do matter). I too have been battling this since childhood. I remember in college not understanding how all my thin friends could eat whatever they wanted and be so thin. I had to watch everything and exercise quite a bit. I’ve lost 47 pounds on a low carb diet (since Jan ’12) but am hitting that proverbial “low carb wall”. The lower I get my carbs the worse I seem to feel. This last week I’ve kept them <20 net grams and I cannot fall asleep. Once I do I'm wide awake at 4 am with a hard heart beat. I feel heavy headed and have a hard time focusing. I'm discouraged by these latest symptoms. I have an appointment Monday with a naturopath to at least investigate thyroid and hormone issues. I sure wish it was easier. Anyway, thanks for the great post! I look forward to your updates.

    • Charles Grashow

      “The lower I get my carbs the worse I seem to feel. This last week I’ve kept them <20 net grams and I cannot fall asleep. Once I do I'm wide awake at 4 am with a hard heart beat. I feel heavy headed and have a hard time focusing. I'm discouraged by these latest symptoms."

      How about trying this – EAT MORE CARBS!!!

      BTW – Naturopath, Doctor of Naturopathic Medicine = SCAM, WASTE OF MONEY

      • RoseNunezSmith

        I don’t want to speak for Trina, but I’ll speak for myself. I’ve encountered this advice — to eat more carbs — many times out on the internet and in real life. The people dispensing this advice are almost always convinced that calories alone matter, and that low-carb weight loss is an illusion, caused by simply eating less on a low carb diet. They rarely believe that decades of low-calorie dieting plus exercise have simply failed, repeatedly, to remove body fat, or wave off such protests as being due to cheating, undercounting, or some other failure to comply.

        But decades of struggle and experience (mirroring Dr. Ede’s experience very closely!) have shown me that calories alone are not the issue: I can eat more calories when I cut the carbohydrates drastically than when I’m eating a “normal” weight loss diet. For example, the last time I tried the standard weight loss diet, under a nutritionist’s supervision, I lost no weight on a very strictly monitored 1,200 calories a day. On a zero carb, meat-only regimen, I lost forty pounds eating between 1,600 and 1,800 calories a day. *Without exercise.* And when I increase the carbohydrate intake even slightly, the pounds (and the hunger) come right back — even when I adjust calories downward.

        This is what is known as a black swan. The fact that even *one person* can *increase calories* and lose weight knocks the “calories and calories alone” thesis off its perch. I don’t expect to be believed — I’m sure I’ll be told that I’m mistaken (or worse, lying) about my experience, and the usual stuff about metabolic ward studies will be trotted out. I’ve seen them, and I agree with Gary Taubes that they’re underpowered and that the dietary compositions are unimpressive for comparison. And even if they were rigorous and otherwise impressive, they wouldn’t move me off my own lived experience. So I suppose I have to be satisfied with that, and with my results, and not worry about other people’s opinions, although it is sad that so many people are getting yelled at to “EAT MORE CARBS!!!,” not just here, but all over Paleo- and NutriGeek-land.

        I do agree that naturopathy is a waste of time and money. However, I feel that way about much of mainstream medicine, too, when it comes to what are called “lifestyle diseases.”

        • Trina

          My main reason for the naturopath is to get proper testing of my thyroid and other hormones. I just don’t want to go with my regular FP and have to explain rT3 or why I want it tested.

          • RoseNunezSmith

            That makes sense, Trina. I know regular MDs can be very resistant to ideas about thyroid. They know what they know, and that’s all what they know. 🙂

          • Trina

            Thanks Rose. I was also dreading having to explain to him how I’ve been eating only to get a lecture on how carbs are essential … you know how that will go 🙂

          • Kim Hale

            I too went to a naturopath last year as a final attempt to solve my fatigue (in & out of ketosis). At least she was willing to do a full thyroid work-up, where my MD would not consider it. And, whereas my MD can never spend more than 11 minutes with me, and never thinks “outside the box,” at least she was able to spend a great deal time listening, taking history, discussing ideas/options and educating.But, it was expensive and in the end all it did for me was to rule out the thyroid issue. Despite the fact that she was a huge advocate of Low Carb/Paleo/Ketogenic diets, she did not accept the idea that a Low carb diet can cause changes in T3 levels and so did try to treat me for several months with thyroid meds to no benefit. In the end, it made no difference in how I felt and my life-long chronic fatigue remains. I’ve been doing Ketosis again since 1/1/13 and HOPING I’ll eventually adapt this time and experience some improved energy. Anyway, I understand the choice to see a ND, and I don’t think they’re just scam artists.

          • Trina

            Thanks Kim – albeit a little depressing 🙂 Dr. Cate Shanahan had a whole write up on people going low carb too quickly and how it does seem to mess with some people’s thyroid. Pretty sure Chris Kresser feels the same way although I know Phinney and Volek say no way. Who knows right?? Argh …

          • Kim

            so frustrating and so difficult to sort through whats what and what your own body is doing! I have been helped immensely in the past year with a few folks who really know their stuff on the internet. I just found this blog a few days ago and am adding it to my list of support resources. I have been LC for almost 2 years and lost about 25 lbs the first 6 months, then painfully slow progress since then. Just started back trying to adapt to Keto again since the beginning of January. So far, the jury is out- I have days where I think my energy is improving, and then I’m right back where I was, barely able to stay up until 8:00 pm and dragging myself around. I’m convinced it’s not my thyroid now, but only because I did the testing and tried the meds with no improvement. I put that theory to rest now. I truly believe that, having been born to an insulin dependent mother and eating an SAD diet was primarily responsible for damaging my metabolism and mitochondrial function. I also know that my body wants to regain (refill those empty fat cells) and it’s a constant struggle. I do hope I can adapt to ketosis and perhaps help heal my body. best wishes on your journey.

        • Hi Rose,
          Well said. All metabolisms are not created equal, and there are some lucky people among us who have either never struggled with weight or who have excellent carbohydrate metabolism, and therefore simply do not understand. I completely agree with you about calories and carbs–when I include carbs in my diet I have to reduce my calories much more in order to lose weight. In fact, it is simply impossible for me to keep my calories within a reasonable range, let alone a weight loss range, if I’m eating carbohydrates. Low-carb diets were the first diets that ever gave me a fighting chance. And ketogenic diets seem to have the potential to help me win the fight once and for all.

          • Charles Grashow

            Trina said “The lower I get my carbs the worse I seem to feel. This last week I’ve kept them <20 net grams and I cannot fall asleep. Once I do I'm wide awake at 4 am with a hard heart beat. I feel heavy headed and have a hard time focusing. I'm discouraged by these latest symptoms."

            So – what would be the problem in adding back some carbs just to see if her symptoms went away?

          • B. Clark

            I would say there is no problem trying that but i would want to know what Trina is actually eating. Some low carbers are eating lousy foods, just low carb lousy foods, I would suggest sticking to real foods and of the best quality she can no processed atkins bars or meals or low carb pastas, diet sodas, sugar free jello, etc. Stop eating out for a while, make everything you eat in your own kitchen. The carb level may not be the issue, she might be feeling bad because she is not getting enough nutrition from her diet as a whole.

          • Trina

            I was eating a very healthy low carb diet (IMHO). All real single ingredient foods. Trust me – I make everything (I feel like I never leave the kitchen … lol). I was eating anywhere from 1,600 – 2,000 cal/day (60-70% fat). I know people like to say if you can’t do very low carb you’re doing something wrong but I’m starting to appreciate that vlc may not be for everyone (women especially). Thanks to input from Paul Jaminet (who was kind enough to respond when I reached out for help) I have added back more fruit and “safe starch”. He told me my symptoms were classic glucose deprivation. It’s been several days and I’m starting to see improved sleep. I wake up once but can go back to sleep. I still get up earlier than usual and my hunger is HUGE in the am. I have not felt hunger in months so this is a new thing. Could be my brain has realized I’m eating more of what it needs and wants me to keep eating (who knows??). All I know is Dr. Jaminet gave me the advice that is turning this situation around. I got his book right away and am going to try implementing his strategies for the “perfect diet”. I’m not looking to lose a ton of weight over night (especially if that means feeling as lousy as I was just feeling). I am looking to eat a diet that promotes the best health – that nourishes my body properly.

          • Someone, Somewhere

            I’m curious: What is Paul Jaminet’s perspective on ketogenic/VLC diets?

          • Trina

            I just started his book but he says ketogenic diets have some value for certain reasons and you can still achieve a ketogenic diet with some added safe starch. I haven’t read that chapter yet so I can’t relay the details. I know he goes into some detail on why getting some glucose through your diet is better for the body and why glucose is so important to all the cells. There’s a great interview with him and Dr. Mercola that covers the glucose issue pretty well. He also explains in this piece how very low carb diets can paradoxically increase LDL and triglyceride levels.

          • Someone, Somewhere

            Makes sense. Thanks for clarifying 🙂

        • Speak, black swan, speak! [I “like” this]

          • I’m not just Rose’s hypeman, I have a very similar experience [MORE calories + less carbs = suprior health and weight mangement]

            Although I don’t agree that naturopaths are necessarily a waste of money. I just think the mass of them are so hit or miss, if you’ve educated yourself enough to separate the helpful ones from the cooks, you’re probably most of the way home to solving your own problems anyway. Having access to a lot of “professionals only” testing via your naturopath?… Golden.

  • Someone, Somewhere

    Dr Ede,

    Thanks for another fascinating post. In fact, this is the most interesting post of yours I’ve ever read. It’s not necessarily more educational—I find pretty much all of your posts educational—but there’s something about chronicles of first-hand experience that I find uniquely compelling. In part, I think, I find it most compelling because I find primary research more credible than secondary research, even if n=1.

    A quick question for you: What made the all-meat diet boring? In particular, what foods or flavors did you crave on that diet?

    The reason I ask is that I trust our instincts (having been shaped by millions of years of unbiased evolution by natural selection) infinitely more than scientists (who have been seriously studying nutrition for little more than a century, whose instruments and objectivity are limited, and who are constantly changing their minds). So I’m curious which nutrients your instincts suggested your body was lacking while you were on an all-meat diet (of course, it may be difficult to parse instincts from conditioning—and the availability of foods not available in our EEA certainly complicates things—but I’ll worry about those issues later).

    A few months ago, I settled on a meat-fruit-salt-and-water only diet. I don’t find that the fruit causes me to gain weight, but on the other hand, I’m a man in my early thirties who has rarely struggled with weight (except when I ate a SAD, and was 40 pounds heavier than now; I don’t, by the way, exercise at all, due to other limitations that I won’t get into here). I was happy to give up grains, nuts, legumes, eggs, and dairy—due to dietary intolerances diagnosed by—and was happy to give up vegetables after admitting that I didn’t really like them and after reading your writings thereon. But as I said before, I couldn’t imagine giving up fruit, because I enjoy it so much and desire it so strongly. Still, I’m interested in your all-meat experiment and would like to see if I can learn anything useful from it for my own diet.

  • Kitty


    One comments:

    Dr. Andreas Eenfeldt’s work, but he also believes that carbs are king…..are you sure this to be correct …..that CARBS are king?

    I am on Keto Day 26 and believe me the adaptation period of 3 weeks, maybe 3 months is not very pretty. All kind of weird sensations. I could never do this on my own. I got support via the Internet. This is not an everyday diet to go on one week, off a week, on a week.

    Calories DO count, check Jimmy Moore’s Ask the experts with Dr. Phinney, there is more than one interview, one about weight stalls. I wish it was NOT like this, he give some advise. I do not control my calories but try to eat according to what my body wants (also protein wise and am still heavy in keto)

    I also read somewhere, for urine keto, small or medium no difference but well a difference for blood ketones, one needs to be in the zone (Phinney)

    Myself, I no longer count, I eat what I want, sometimes to much, far to much. Not eating at night just does not suit me but I know it to work, so does eating once a day, but have past those experiments and will for now not go back to them. The first weight loss is all water and maybe some fat see their book(s). I did put on some little weight (4 lbs) after no longer restriction my food. I was quite thin after a raw vegan diet and stopped because I had problems with it. I can put back on that weight, but not much more otherwise it shows….

    I am a seasoned dieter, have similar problems you describe here, tried them all. So far like Keto not withstanding the difficult first month so far. I am more balanced, do not think of food all the time, solved my terrible life long Low blood sugar. But even having dieted my whole life, Keto is different and having somebody who also eats that way or have been there before is a must for me…..Not sure were this will lead me, but having found this, I am not so easy going to give up…..this is not an easy choice, maybe in a month or three, it will be plain sailing, but not in the beginning

    Why do people go through all this trouble? Why indeed? Because they have tried everything else for sure and nothing has worked so far. People who never give up to find a solution. Those are special people, those are fighters….so easy to eat all the so called ‘normal’ food but where does it lead us, if we go by what the older people are eating and the diseases they get: cancer, or many other diseases, diabetic as most people do these days, not sure if I want to go that way


    • Hi Kitty
      Thank you for your comments. Yes–why would any of us go to what some others may think of as “extremes” to get weight and health under control? Indeed–because we have tried everything else and it didn’t work. I hope you are able to find a way that works for you. If I could eat a wide array of normal foods in reasonable amounts, feel well, and not gain weight, you can bet I would do it. Unfortunately…not so lucky.

  • JEY

    Dear Dr Ede,

    I only recently learned of your website, and am impressed with not only your knowledge, but the clear and understandable way you present information. The cancer series and now your experiment with a ketogenic diet is excellent. Notes on your glucose readings this post and the comment about Physiological Insulin Resistance and Hyperlipid in the last post, leads to my question about ketogenic diets for possible cancer prevention.

    I had cancer in 2006 and post treatment used the vegetarian Cancer Project (PCRM) diet; quickly gaining 60 pounds. After reading Good Calories, Bad Calories, I switched to the 20g low carb diet used by Dr. Westman at Duke, but with a Paleo focus on whole, non-processed foods. Very little dairy, moderate protein. I lost the weight, have had a normal BMI over a year, and always remain under 50g ketogenic.

    For the past two and half years eating very low carb, my fasting blood glucose has been slowly rising from the 80s to 101 last week (LabCorp serum tests). Fasting insulin went from 5.4 to 9.3. This and other symptoms lead me to Paul Jaminets research into issues he attributes to “zero-carb” diets, especially Physiological Insulin Resistance. He writes in Perfect Health Diet that it is not the same as pathological insulin resistance. But what of its affect on my prime reason to be ketogenic all this time? Whatever it is called, my FBG and Insulin is rising, and this cannot be good for cancer prevention. At home morning FBGs have also been over 100. Whoa! btw, I feel great on a ketogenic diet, am a vibrant fit 63, take no medications, but serum tests for lipids, glucose and insulin are heading in the wrong direction.

    • Hello, Jey

      Thank you for sharing this very interesting personal history, and for your kind words about the site. Congratulations on your recovery from cancer, and on your Incredible ability to normalize your BMI! I wish I could explain why your blood sugar and insulin levels are rising, but am hopeful that you will figure it out. All I can offer, unfortunately, is questions–has the composition of your diet changed? Do you count calories, and if so, is it possible that your caloric needs may be changing over time, and that lowering your calories a bit may be helpful? Has your activity level changed? Do you measure serum ketones, and if so, have those changed (if not, I would recommend it to be sure the diet you are eating is truly ketogenic).

      There is no need to answer here in writing unless you wish to do so; these are just questions that may or may not be useful in your search for an answer. There are also medical conditions that can cause high blood sugar and insulin levels but it sounds as if you are already working closely with a clinician and that other issues have been ruled out…I really wish I had the answer…as you can see from my own results, my glucose readings are still higher than i would like. If they don’t eventually normalize once keto-adaptation occurs, we will be sharing the same dilemma!

      • JEY

        Thank you for your response. The first lab indication of high FBG and insulin was only two weeks ago. Now with fresh glucose and ketones strips, I will again watch these numbers at home. I am blessed to have Dr. Westman’s guidance, but Paul Jaminet’s work on eating to “natural glucose intake” and problems with zero-carb also resonate with me. Over the time low carb, I have had high LDL and low thyroid (both corrected with more non-starchy carbs), and now this apparent physiological insulin resistance. Two dinners I added 200 calories of “safe starch”; FBG was in the low 80s the next morning. Ummm. PHD includes advice for Therapeutic Ketogenic Diets, so I will be experimenting with that while following your NK with great interest.

        • That is very interesting indeed…If my own sugars don’t come down on their own after a few weeks I may just have to try that…

          • Chris Adams

            if you haven’t already done so have a look at Paul Jaminet’s “safe starch” post, it has been recently updated. He discusses this topic at some depth.

          • JEY

            New to me, Michael O’Neill’s blog Ketopia surfaced while researching Physiological Insulin Resistance.

            Lists some I hadn’t found, but omitted Jaminet’s good safe-starch and zero-carb posts. The new PHD has practical advice how to include them in a ketogenic diet.

  • Paul N

    I had read a comment from someone on one of these sorts of forums, who could not “achieve ketosis” no matter how much fat they ate.
    They then, on advice of a friend, took 2tbspns of flax oil, and was in ketosis the next day. mIght be worth trying since you are measuring things so accurately.

    • Hi Paul
      Thank you for the suggestion–I will add this to the list of possible mini-tests to do once I’ve been on this plan for a month or so.

  • Hi SS
    Thanks for reading, for saying more about your diet, and for your interesting question. I wasn’t craving anything on my all-meat summer diet, it was just a boring diet–especially since I don’t do well with most spices and sauces and such, it was just lacking in variety. Eating plain meat every day after living a life of eating all kinds of foods made me wish for a wider variety of flavors and textures or something. But no particular food was calling to me…

    • Someone, Somewhere

      Hi Dr. Ede,

      Thanks for answering my question. If you don’t mind, it leads me to a follow-up: What foods did you add back first after abandoning the boring all-meat regimen?

      • I wish I could remember–that was last August–but what I typically supplement my all-meat diet with are the very few plant foods I can tolerate (cucumbers, lettuce, small amounts of berries, olives…)

        • Someone, Somewhere

          Thank you, Dr. Ede. It’s interesting to read what someone who has a very sensitive system, like yourself, can tolerate, though I imagine it varies somewhat from person to person.

  • Congratulations on taking the plunge and I realise the first few weeks will be difficult, you will feel tired, low energy, etc… as your body re-learns to use ketones.

    I have helped many people successfully keto-adapt and I am concerned about your caloric restriction, especially at the beginning. It seems as though you are putting the cart before the horse.

    I highly suggest abandoning all calorie counting, count only total carbs and protein, eat according to hunger, and let your body establish itself. The diet should become self regulating if you are eating according to hunger, imposing a caloric limit is counter to the process and is in my mind the number one reason the diet fails. You CAN eat when you are hungry on this way of eating, that is the biggest benefit, and your body will learn the difference between true hunger and simply running low on carb.

    Eat big full meals, no snacks, when true hunger hits, eat another big full meal. If you are going to take the red pill and dive into the Matrix you gotta trust the process.

    Believe it or not, once keto-adapted eating excess calories will have a totally different effect on you than it does now. You will feel “compelled to move”, your body will zing with energy if you are properly eating high fat, moderate protein, very low carb ketogenicly.

    You will simply feel compelled to move. The problem will not be a food surplus but an energy surplus and it will be a joy to answer. But the first few weeks is very tough. For me keto-adaption took 5 weeks! But after that… WOW! My entire perspective on what a truly great way of eating is changed overnight!

    Good luck!

    • JEY

      To eliminate headache, lack of energy and more easily transistion to ketogenic, Phinney/Volek/Westman emphasize how utterly important it is to get 5g of sodium/day on a VLC diet.

      • Hi Jey

        Thanks for the tip–yes, they are big proponents of salt in their books, and I do eat quite a lot of salt:) My energy is great lately, but I still have a mild headache in the morning before eating breakfast. As soon as I eat, it goes away.

    • Hi Danny
      Thanks so much for the wisdom, advice, and encouragement! I am very hopeful that I will discover that calories do not matter; I am tracking them to see whether this will be as true for me as it seems to be for many other people. My challenge is to eat more animal fat without eating more protein, because animal fat is the only fat that agrees with me, but I am continuing to tweak and experiment. My appetite has been in excellent control for the past few days and my energy is good so far. Would you care to share more about what you do? It sounds like you have some solid professional experience under your belt:)

      • melancholyaeon

        Dr. Ede:

        Listen to Danny very closely, please; his advice is sage. Do not restrict calories to start: you will only crash your thyroid quickly. Eat freely. If you can’t eat butter and coconut oil, try olive, red palm or MCT oil to get to 80% fat. MCT is esp. helpful.

        As you know, I am 40+, wear a junior’s size 7, and have been NK since before Jimmy started. My immediate impression is that you are still eating waay too much protein for a women your age and size and not enough calories. I would knock the protein down if you wish to get to between 2-4 in a stable way on the blood ketone meter. And by down, I mean 50-60g.

        Please recall I have had success eating 80-2% fat, 12% protein, 6-8% carbs, with total protein capped at about 60g. I’m eating about 1650-1700 cals. a day. Keto definitely gives you “calories for free,” because as Danny says, you find you shortly cannot stop yourself from moving. You will walk by a gym, see a spinning class and suddenly think “what fun!”

        Or your friends will say “let’s go to the movies,” and you’ll say “I really feel like playing Frisbee in the park with my dog!” A dog btw is the best ketosis partner because Dog always be up for walking when you feel like walking, which will suddenly be about 10 times more than anyone you know. I highly recommend you borrow a dog if you don’t have one already for this experiment. 🙂

        As for your questions:

        “My blood sugar is still pretty high despite high ketones, but I
        think all bets are off during first few weeks, as “keto-adaptation” can
        take 3 weeks or more. [Keto-adaptation refers to the body’s ability to
        efficiently use ketones for fuel instead of carbohydrate.]”

        No, “all bets are not off,” if I may be direct with you. I hope you understand that I say this not to be obnoxious, but to be clear, frank and factual. Your blood sugar is high most likely because you are eating too much protein. Keto is not a magical state that will change the protein issue; I doubt you can get to stable keto like this. Proper keto will plunge your sugar levels and keep them amazingly steady once you have managed your protein level down. Your blood ketones of 1.5 are not high, they are moderate. High would be 4. But as Volek says plainly, the longer you are keto, the more efficient your body becomes at using them, so your measured levels will decline over time. As Jimmy Moore himself is seeing.

        “Do I need to eat more fat to get higher ketones, or is it just a
        matter of time?”

        Eat more fat. As Volek says, “when in doubt, eat more fat.” Please eat more fat now. 🙂 Time is not the issue, quantity of fat is the issue. Eat more. Step away from the computer and drink some very high quality olive oil if you can’t eat a stick of butter. 🙂

        “If I were to eat more fat, that would mean more
        calories–would my weight loss slow down or stop?”

        Your question is the wrong one, if I may be plain. Please forgive my straight-talk, I don’t want to seem to lecture or anything. I think a woman your age & seeming height should be eating between 1600-1750 cals in stable ketosis, and when you are starting, as Danny says, I wouldn’t worry about calories or weight loss at all.

        I do frankly think you are undereating now, if I may say so. I would encourage you to up your fats and recalibrate your diet to 60g total protein, and then based on 60g & 1700, calibrate the rest of your diet to 80% fat. The remainder: olives, cucumbers, and whatever little veggies you can tolerate. That’s really a minimum for you now – again, I would encourage you to eat freely and not worry about cals now.

        You will have to try this level for 2-4 weeks to see if it’s working for you, and by try I mean measure blood ketones twice a day. You should try keto because you want to stabilize your blood sugar, experience mental clarity, gain higher energy, and discover this mysterious but unstoppable drive to exercise. You may begin to lose weight after that.

        But keto will not magically guarantee weight loss, esp. if you gorge and binge up to 2700 cals day, as you report above in the past. The benefits of keto are not necessarily weight loss. 🙂 And yet at the same time, most people do in fact lose weight on a properly formulated keto plan. The issue is simply that most people aren’t following it correctly – they eat too much protein (esp. at night), they try to limit fat, they try to eat too few cals.

        Forgive my frank tone here, and please accept my best wishes. Outside of keto, I would also agree with Charles below – if you are truly a Hyperlipid, all-meat kinda individual, just do that. Keto requires strict non-varying focus. And yet for all it’s rigor, it’s still easier than low-fat calorie-counting.

        If the all-meat works best for you, just apply that focus there.

        • Maria

          What is your take on physiological insulin resistance, melancholy? I keep reading that people in ketosis can have FBG of 100-110 while having good A1c.

        • I think you and Danny will be happy with my week 2 results:)


    The metabolic system does seem to be the cause calories mattering. This video pretty much says the same.

  • Kitty


    Here again. I was thinking about your music and so called hallucination….well if you would be a student of Lucid Dreaming or OBE, you would have been happy to have this experience as this would have been a contact with your Other Self
    This is the WHY people do so called Spiritual Fasting as they get those experiences and many, many more.
    The question is, depending from which angle one is seeing it, is it a hallucination or is it a contact with the non visual world
    I know this is not the main subject, but while we are at it and other people may have the same experience… is just that most people have no idea of the ‘other worlds
    Only two references: Lucid Dreaming by Dr. Robert Waggoner, and Dr. Stephen Laberge just for a start…..just to get in the right direction

    Now, if this happen next time you Meditate, Fast or does any what they call Spiritual exercises, you will not be surprised at all, once you know and understand

    By the way Danny is like somebody who has done the hard initial work already…the beginning is no easy journey…..I am at day 27…..nearly over the worse


  • Are you me? LOL! I read your posting and you sound exactly like me! I’m a little older, 54, but I’ve run into all the issues you have. I was one of the very frustrated middle-aged women asking Phinney why I can’t lose weight on LC — no good answer from him unfortunately — during that Jimmy Moore interview.

    On top of everything, I have a defunct thyroid gland so my thyroid meds play into that too. I think I’m about the same BMI as you too… just slightly above the normal weight cut-off. The very slightest deviation from a controlled calorie, Low carb diet and I bounce up a couple of pounds.

    I wish Phinney/Volek would study us broken, middle-aged women and figure out what is going on with us that we can’t lose weight except taking extreme measures… and then only temporarily.

    When I read this:

    “Oddly, most diet gurus are men without a serious history of weight problems…”

    I suddenly knew we were the same person. I’m always making the observation on the low carb community I frequent that men have no useful diet advice for middle-aged women.

    Anyway, so excited I found my clone writing a blog. I shall have to read it compulsively!

    • Dear Other Me,
      How nice to finally meet you:) I’m sure you are, in every way, a fabulous person. This goes without saying.

    • Eknola

      And I make us triplets

      • Welcome to the family, long-lost sister! My guess is that we have many thousands of other sisters out there…

  • Kitty

    I would like to ask about bowel movement. Maybe not the nicest subject but a fact of life
    Very low carb and a good bowel movement, who to achieve this?
    Any one with trouble or with solutions?

    • Right–not a fun topic, but I had this issue with the traditional Atkins diet, which I tried over 10 yrs ago. For me it was not the lack of carbs but the presence of specific foods that gave me trouble (certain kinds of dairy foods, nuts, cruciferous vegetables–if you haven’t seen my blogpost about constipation, there is a list there). Once I removed them, I was fine.

  • Hi Dr Georgia, I find calories do matter for me as well. I need them UP! If I don’t get enough calories I get cold and weak and can’t exercise. If I just eat to hunger on VLC I don’t eat much because I’m not very hungry. I don’t eat very frequently but when I do, I usually sit down to a very serious plate of meat. Up until that time I mostly exist on buttered coffee. This practice had helped, not hindered my weight loss. High calories help me see this as a sustainable way of eating. I was interested in life extension practices long before I was interested in low carb diets. CR and I parted company many years ago [I’d rather just die]

    • Hi Donovan
      Thanks very much for your take on this–in this phase my goal is to replicate what Seyfried recommends, which is restricting calories as well as protein/carbs. However, no worries, I will absolutely increase them (by increasing fat) if this current experimental phase doesn’t work well. In fact, I will at some point increase my fat calories regardless, as an experiment, and am tracking calories partly because I want to be able to document the differences in metabolic response, etc. at different calorie levels. At least at this point (day 11) I have not felt hungry or deprived, but we shall see how things go!

  • JEY yesterday (Jey, I’m posting this on your behalf b/c the spam filter wouldn’t let it through):

    A large website for everything low carb and ketogenic, for consumers and professionals alike, is the Nutrition & Metabolism Society.

    Info on Diet and Cancer, ketogenic diets (http://www.ketogenic-diet-reso…, a link to the NMS Journal in the professional section for current relevant studies, and much more embedded under each tab.

  • Maria

    Dr. Ede,
    I am wondering why you monitor urine ketones and not blood? I have only ever read that urine ketones are not a good indicator for ketone levels, and that someone who is using them efficiently will simply not show many of them in urine.

    • Maria

      The ketones that is, using the ketones efficiently, not the sticks 😉

    • Hi Maria

      I’m monitoring both the blood ketones and the urine ketones every day because I’m curious to see how they relate to each other over time, whether people really have to purchase the very expensive blood ketone strips, and whether it is necessary to test blood ketones every day or not.

      • Maria

        I saw that when I re-read your post! My apologies. And thank you! It would be wonderful to see the correlation!

  • mO

    Just stumbled upon this website today. Can you be more specific about your all-meat diet? What it a low-fat high-protein? If not, what types of fats did you eat and how much?