June 5

Ketogenic diet and brain energy

32  comments

An article in the current issue (May 2007) of Nature Medicine discusses the mechanism underlying the well-known anti-seizure effect of the ketogenic diet.
I found a few statements in this paper that I thought readers of this blog would find amusing.
The article starts out:

Doctors have for nearly a century prescribed a low-carbohydrate diet to help prevent seizures in people with epilepsy, but they had no idea why it works—until now.
Harvard University researchers in April reported that the strict diet—dubbed the ketogenic diet because it induces a state of ketosis, in which the body is forced to use fat for energy—may enhance the function of electrical switches in an area of the brain that controls seizures (J. Neurosci. 27, 3618–3625; 2007). With further testing, the mechanism could reveal potential drug targets, experts say.

Yep, that’s science for you. We’ve got a perfectly safe and acceptable solution to the problem in the form of the ketogenic diet, so let’s try to find a drug that will do the same thing. And cost a zillion dollars. And cause side effects. And… But, friends and neighbors, that’s how science – funded by Big Pharma – works these days.
The article continues:

The diet enhances the protective role of energy-, or ATP-, dependent potassium channels in the brain, which control the electrical firing of neurons that release the neurotransmitter gamma-aminobutyric acid (GABA) in a region of the brain called substantia nigra pars reticulata, the researchers found. Those neurons are known to be associated with seizure control, says lead investigator Gary Yellen, professor of neurobiology at Harvard.
“The diet affects multiple metabolic features,” notes Philip Schwartzkroin, a neuroscientist at the University of California, Davis. “Some are related to antiepileptic effects of the diet and some are irrelevant.”
Schwartzkroin says there are many other cells in the brain that have energy-sensitive potassium channels that might be affected by the diet. “How that might be integrated is not even discussed,” he says.

So, if we’ve got such a good tool for managing brain energetics with the ketogenic diet, tell me again why we need drugs?

Developing a drug that could replace the diet is key because the eating regimen is arduous. The diet consists entirely of fats and protein in portions that are precisely weighed and timed, and dieters must be monitored by a doctor. Cheating on the diet—such as eating a candy bar—can bring on a seizure in minutes.

The eating regimen is arduous?!?!?! Ah, tell that to the many people who have been on low-carb diets for years and feel better than they’ve ever felt. I sometimes wish that I would have a seizure within moments of cheating on my low-carb diet. It would certainly go a long way in preventing my cheating.
And, not only does the ketogenic diet work for epilepsy, but other disorders as well.

The diet is so complex, in fact, that doctors have seen benefits in people with other neurological diseases, such as Alzheimer’s and Parkinson’s diseases.

How does it work for Alzheimer’s and Parkinsons and a multitude of other disorders? You can find out this coming September when our partner’s book comes out. Dr. Larry McCleary, a noted neurosurgeon, has written a terrific book about all this that explains how a low-carb diet works to improve brain performance. By reading this book, you will be far ahead of most researchers working in the field in terms of your understanding of brain energetics and how a ketogenic diet works to help the brain function better cognitively while warding off Alzheimer’s and a host of other brain disorders.


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  1. I don’t faint if I have a candy bar either, but I do blow up like a balloon if I have even a small amount of wheat. But the thing that really keeps me going on the low-carb diet and what prompts me to push it with my children and friends was watching my husband slowly deteriorate starting with GERD, and then Crohn’s disease, which they later decided was ulcerative colitis. Toward the end, he had what looked to me like seizures and which were probably due to dehydration. He even had one in the hospital after having his second major surgery. It scared the heck out of the nurses. The doctors didn’t know what the cause was but said that it might “possibly” be dehydration. They recommended Gatorade. Nine months after having his colon removed, and six months after this second surgery, he died of a heart attack.
    Thanks so much for your books and for this blog. Keep preaching the message and maybe eventually they’ll get it. I’m looking forward to reading your partner’s book.
    P.S. I suspect you cheat because of the high-stress life you lead.
    Hi Grandma Ann–
    No, I cheat because I’m a weak-willed worm.
    Thanks for the kind words about the books and blog.
    Cheers–
    MRE 

  2. Hello Mike–great post. Reminds me of the mainstream approach to treating diabetes. My stepdad is diabetic–I have tried to give him a little nutritional info but it’s futile. His physician has him on all sorts of meds but tells him it’s OK to eat bread, rice, dinner rolls, etc. because they fit in with the ADA’s high-carb recommendations. Guess the ADA thinks it’s better to keep upping diabetics’ medications than to recommend a diet which would, in many cases, make medications unnecessary.
    Hi Paul–
    Yep, that’s the ADA way: give ’em a lot of drugs and/or insulin to treat their elevated blood sugars that probably wouldn’t be elevated without the ADA recommended diet.
    Cheers–
    MRE 

  3. Um, without insulin, type 1 blood sugars would be elevated even if they ate nothing.
    However, it’s much much easier to control type 1 on a LC diet.
    Indeed it is.  And requires much, much less insulin than if following an ADA recommended high-carb diet.
    Cheers–
    MRE 

  4. Sir thanks.Super post though i couldnee get the actual paper.
    After eating this way for 12years my major discovery oer the past 6 months has been sat fat.
    If i eat a fair bit of it..coupled with the other fats have used oer these past years i get hardly if any cravings and thus am never tempted.
    Also the ketones seem to have a euphoria about them that makes one feel massively joyful.
    You and Veech and Seyfried should write a book together !!
    Sinc.
    Hey Simon–
    I excerpted the best parts of the paper.  It really wasn’t a research paper, but more of an editorial about the research going on with ketogenic diets and epilepsy.
    Cheers–
    MRE 

  5. Hooray for this—-I knew it to be true—
    One of the disorders I’m sure to see in the new book is Bipolar disorder. That is something I suffer from—but since finding the research about the ketogenic diet helping the disorder—I’ve upped my fat intake. I average 70%—now that is lower than they use for the seizures which is 80% but it made a big difference in me.
    Every summer—I end up in a severe manic episode–in Jan I upped my fat and so far so good—I’ve been following low carb for 3 yrs now and my moods have been much better—well except for a stint in the hospital last summer due to a carb binge depression
    I take enough meds for this—if I can keep stable by changing my diet—sure–I’d rather do that
    But the pdocs don’t want to hear about low carb anymore than the reg docs.
    Hi Bama girl–
    I think when Dr. McCleary’s book comes out in September you should get it.  I think you will find much good information on fat and the ketogenic diet as related to your condition.
    Cheers–
    MRE 

  6. So come on Guvnor lay in with yr thoughts on Libby, his sentence, Pres pardons etc, please ?
    Hi Simon–
    My thoughts on the Libby deal…
    I think it is a travesty.  I hate the whole special prosecutor situation.  Clinton had a chance to get rid of the special prosecutor act but chose (for who knows what reason) to renew it.  Special prosecutors cost the country a fortune and their job (at least in their minds) is to prosecute.  They don’t seem to feel that they can justify spending all the money they spend if the end result of their quest is that there is no misdeed, so if there isn’t one, they create one.  In almost every case what it does is to criminalize what is basically politics as usual.

    In the Libby situation, that twerp Patrick Fitzgerald was out to show that Libby was responsible for the leak that outed Valerie Plame.  When former Deputy Secretary of State Richard Armitage revealed that he was the one who told Novak about Valerie Plame, Fitzgerald should have gone away.  But instead he continued to pursue Libby – not for the original reason, i.e., the leak, since that reason had gone away – but for what Fitzgerald contended were Libby’s lies to the Feds when they interviewed him.  But Libby wasn’t the leaker, so what did it matter?  And to get sentenced to jail for lying to a government agent (which is why Martha Stewart went down) is the height of hypocrisy since government agents lie to us at every opportunity.  It’s even been held up in the courts.  If a federal agent is questioning a suspect in a crime, it’s perfectly acceptable for that agent to lie to the suspect in an effort to get him to admit to something and incriminate himself.  It’s fine for the agent to say something along the lines of ‘your friend (or partner or whatever) has already told us you were at the scene, so you better come clean with us or it will really go down hard for you’ when the friend or partner has said no such thing.  And it doesn’t matter if the guy does come clean, he still goes down hard.  So they lie right and left with protection.  But we can’t lie to them?
    If Bush has any testicular fortitude he will give Libby a full pardon before Libby has to spend a day in jail.  But, if I had to bet, I would put my money on Bush wimping out.
    Cheers–
    MRE 

  7. Oh yeah, I find it very arduous to force down that steak and put real cream in my coffee. Sheesh.
    Well, yes, we’d much rather give someone an expensive pill to take. After all, Big Pharma isn’t making any profits off a LC diet.
    BTW, I recently got my Slow Burn DVD’s. I still have to watch the instructional DVD first, but will be off and running soon with my workouts.
    Hi Esther–
    Keep me posted on your Slow Burn experience.
    Cheers–
    MRE 

  8. Oh, also meant to say that you aren’t the only weak-willed worm around here…
    I’m glad to know I’m in good company.
    Cheers–
    MRE 

  9. Thanks for posting. I’m always glad to hear about new books coming out about low-carb. I’m also looking forward to Taubes’ new book (??end of this year).
    Are we really “making progress” with the powers-that-be, however? It’s such a battle, but I was hoping Taubes’ book would cause a bit of a low-carb “revival,” and the neurosurgeon’s book sounds terrific as well. Keep up the great work!
    Hi Jill–
    Last time I spoke with Gary Taubes he was going through the galleys of his book making the final editing changes.  Since the galleys are the last stage before printing, I suspect the book will be out pretty soon.  Probably in September, but I wouldn’t think any later than the first of the year.
    Cheers–
    MRE 

  10. Drugs to treat epilepsy that can be treated with diet….more drugs to treat the diabetes from all the carbs you eat…more drugs to treat the heart disease caused by high insulin levels….and let us not forget the drugs to treat the side effects of all these drugs!!
    Yep, that’s the American way!! Heaven forbid you feel “deprived”. And of course we can’t have people not eating bread and grains…after all, without these people don’t get their needed folic acid, iron and other vitamins that are added to breads and cereals!!
    Makes perfect sense to me!!!
    I’ve also tried to talk to family members about treating their diabetes, etc with diet, but everything falls on deaf ears. Actually I suspect they all think I’m a nut case….after all, since starting on low carb I’ve cut out almost all the meds I’d been taking for stomach problems, “high” cholesterol, arthritis, etc, etc, etc.
    One of these days I keep thinking the medical industry will smarten up….but then I remember all the money they rake in treating these diseases…and how much more they’ll lose once the lawsuits start!!!
    Hi Cindy–
    I don’t think the medical industry, i.e., Big Pharma, will ever smarten up because it would cost then way too much money.  They’re getting filthy rich maintaining the status quo.
    Cheers–
    MRE 

  11. I sometimes wish that I would have a seizure within moments of cheating on my low-carb diet. It would certainly go a long way in preventing my cheating.
    This made me laugh out loud.
    BTW, I agree with Simon about the positive side effects of saturated fat. I drink an ounce of coconut oil a day and my carb cravings have dropped to near zero.

  12. Hi Mike,
    One question which has always bothered me is, given that humans evolved on a hunter gatherer diet, and human metabolism is suited to burning ketones/fats for energy. Then why is it that we need blood glucose as an essential resource, and as a consequence insulin and all the metabolic machinery related to it. Why are vital body organs so dependent on glucose? Why evolve such a mechanism?
    I was just reading how quickly saliva can break down starches, and if you continue down the digestive tract a significant amount is dedicated to providing humans with the capability of dealing with carbohydrates in some fashion. Why evolve such a GI tract if carbs were only part of, if at all, of your nutritional intake? And why is blood glucose so critical to human survival, to low and you can die.
    I don’t have a clear answer to these questions and welcome your thoughts.
    Best regards,
    Tahir.
    Hi Tahir–
    This is a great question and I’m going to deal with it in an entire post.
    Cheers–
    MRE 

  13. Hey Mike,
    I’m back and you post this. Nice. The frustration vented at science today is really just a symptom of a system with broken incentives. I could spin a tale of big government funding research without looking to do technology transfer and make drugs, but we’re not for big government around here. But when the market funds science, the market is going to expect a return. That return isn’t going to come from a better diet. The money, as Chris Rock noted, is in the medicine, not in the cure. It’s hard to get rich telling people to eat from the margins of the supermarket, but a lot easier with pills.
    I am reminded that in one of your books you note that the medical establishment treats the symptoms of MetSyndrome, without treating the underlying cause. The pill focus of modern science is like high blood pressure or an excess of abdominal fat. Symptomatic, not the root problem. Just as PP(LP) treats the underlying cause, any complaint about the pill focus should be directed at the underlying cause, the profit requirement for science. I don’t have a good, non-government solution, because we’re talking a public good and that’s what government is good at.
    Hi Max–
    Glad to have you back. 
    Unfortunately you (and Chris Rock) are absolutely correct.  There is no money in wellness.  Only the treating of unwellness, and only with drugs.
    But, I’m not so sure you’re correct on the government as the vehicle for public good.  I think it’s often just the opposite.
    Cheers–
    MRE 

  14. This is slightly off-topic, but my earlier post may have gotten lost since it was to last months’ topic.
    You answered as follows to two other
    comments concerning fat. Specifically, whether or not [dietary] fat can be converted to glucose:
    “It’s a difficult question. […] Fatty acids cannot be converted to glucose. But, when the fatty acids are stripped away from the glycerol, the free glycerol can combine with another free glycerol to make glucose. This doesn’t represent very much glucose, however.”
    Then, to another reader you answered:
    “If one is on a low-carb or zero carb diet for a long period of time, there shouldn’t be much of any glucose made from muscle as long as there is plenty of dietary protein with which to make the glucose. As long as plenty of protein is consumed, there shouldn’t be any muscle loss.” (I assume this is because the muscles are using glucose made from protein?)
    Dr. Atkins, in his “New Diet Revolution” states that a person should not eat excess protein as that is converted to glucose which prohibits a person from burning fat.
    Yet, I understood you to say that the liver “only produces enough glucose to nomalize blood sugar, not fuel muscles.” Could you please clarify this issue once and for all?
    1. What does it mean when you say “a person is burning fat?” From what you wrote I suspect it’s not dietary fat, but perhaps fat produced by our bodies. But, in response to what?
    2. While “fat-burning” what do the muscles use for fuel and where do they get said fuel? What’s the best way for a “fat-burner” to fuel up?
    – Charles (confused runner, who, by the way, has been steadily dropping my 400 meter sprint time over the last month on 30g per day or less of carbs.)
    Hi Charles–
    When a person is burning fat that means that he/she is burning primarily fat for the fuel required for daily living.  That fat can be dietary fat and/or stored body fat.  It’s usually some of both.
    When a person is burning fat the fuel for muscular contraction comes from that fat that’s being burned.  There is stored fat within the muscles that are used for the purpose.  There is no need to ‘fuel up’ as the muscles contain plenty of fat.  I’ve forgotten the actual calculation – it’s in one of our books somewhere – but an average size person, not an obese one, but average size, has enough fat stores to run from St. Louis to Miami without ever eating.  So, don’t worry about the fat stores, as long as you’re getting plenty of low-carb fare, they’ll take care of themselves.  What you have to do, though, is stay on the low-carb diet so that you get adapted and stay adapted to accessing and burning fat easily.
    Best–
    MRE 

  15. Dr. Mike:
    Just a terrific post – thanks! (Since I’ve been on the PPLP track, only about 9 weeks, I have not generally been tempted by bad stuff like candy bars. The fact that I can do some grapes, strawberries, blueberries, etc. helps a lot in that regard I think.) But on the main issue here, I go ballistic thinking about and wondering why so many “mainstream” medical professionals and/or nutritionists and the like can’t (i) figure this out, (ii) start thinking independently with their own brains (rather than letting pharma or food purveyors or other commercial interests do it for them) and (iii) stop advocating stuff that is truly harmful to real people. Ok, enough ranting for now.
    PS – If you have time, could you please address and/or expound on this issue: why can the initial phase of positive dietary changes / weight loss cause blood lipid test results to be skewed? Is there a sort of typical time frame before everything “shakes” out after starting reduced carb / adequate protein?
    Also, are there any labs around the USA where an individual can get tested for the level of LDL “b type” vs. LDL “a type” at a reasonal cost and without Rx? The standard lipid testing doesn’t seem to tell us (or our Dr.) all of what we really want and need to know.
    Regards,
    Wil
    Hi Wil–
    There are a number of reasons that lab values are all over the place early on in the dieting process, chief among them the fact that the fat cells tend to store a lot more than simply fat.  When these cells start to give up their fat stores, the other stuff comes out too and can alter lab results.
    I don’t know of any labs that routinely test without a physician’s orders, but the test you seek – the LDL particle size test – is available at virtually all commercial labs of any size.  The last time I ordered one for a patient it cost about $180.  I’m sure the price had fallen by now.  Simply ask your doc to order the test for you.  If you’re paying the freight he/she shouldn’t have a problem with it.
    I quit ordering this test on my own patients (unless one absolutely insisted) because there was an accumulation of medical literature that showed that triglycerides (which are a part of every lipid panel) were a surrogate measure for LDL particle size.  If triglycerides go down, as they always do on a low-carb diet, LDL particle size goes up.  and vice versa.
    Cheers–
    MRE 

  16. If ‘They’ could, they’d develop a drug that would replace ALL diets. Why eat actual food when you can just pop a couple of pills?

    Reminds me of the motto of my Organic Chemistry class years ago: “Why grow naturally what you can synthesize from petroleum?”
    Hi Bob–
    We must have had the same O chem professor.
    Cheers–
    MRE 

  17. You know, I’ve been reading lately everywhere and here and there about how “boring”, “difficult” and yes, “arduous” low carb eating is. I think mainstream science is running out of negative things to say as the dangers of low carb eating are contradicted by new research coming out, therefore they have to find other things to say.
    I don’t know how we got to the point where everything has to be cured with a pill instead of diet modification that can be done by us at home. I know that it starts with the phenomenal advertising budget of Big Pharma — but is the ordinary Joe Public really that brainwashed?
    Hi LC–
    I fear that Joe Public really is that brainwashed.  I can’t tell you how many times I’ve had patients come to see me to lose weight or solve some other health problem easily amenable by nutritional changes and had those patients say  to me:  Doc, isn’t there just some kind of pill I could take?
    That’s where the Big Pharma brainwashing has really taken: people think that sooner or later there will be a pill for everything if there isn’t already.
    And as long as Big Pharma keeps advertising and keeps underwriting studies, things aren’t going to change.
    Best–
    MRE 

  18. “I sometimes wish that I would have a seizure within moments of cheating on my low-carb diet. It would certainly go a long way in preventing my cheating.”
    Good one. I do feel awful shortly after eating a high-carb indulgence. My heart does a slow heavy beat and sometimes even get pain and numbness in my left arm. I did mention this to my doctor and she just said that “insulin is toxic to the heart”. Hmmm, maybe I should switch doctors.
    Regarding the ketogenic diet; I read an article about this recently in a British paper, about a British child with epilepsy. They claimed that as little as TWO RAISINS could cause this child to have a seizure. Well now I do call that an arduous diet if the kid can’t even have two raisins.
    It’s very hard for us busy folks to cook every night, but that’s what I do. I make big low-carb meals every night so that we have something to take for lunch the next day. Not only can it get boring, but if I don’t have time to cook that night what can we eat? We have to fall back on convenience food sometimes and it’s depressing. Can’t these fast food places have some decent low-carb items for us? And I sure don’t mean the nasty wilted salads from McD, et al.
    Thanks for letting me vent.
    LL
    Hi LL–
    Please feel free to vent any time.
    I would get another Doc and get the arm pain checked out.  Get someone to at least run an EKG while you’re having the arm pain.  If you are experiencing left arm pain and your EKG is normal, it’s most likely not caused by your heart.

    Keep me posted.
    Cheers–
    MRE 

  19. Is it true that “insulin is toxic to the heart”? Sounded like bunk to me and I was pretty surprised that she had no advice and gave no further explanation.
    I only get it when I’ve been following a fairly rigid LC diet and then have something outrageous like cake.
    If I’m following a less stringent LC diet then I can have some higher carb things without causing such an extreme reaction.
    It’s like the heart becomes immune to a certain extent to the insulin?
    Inquiring minds want to know. Thanks!
    Hi Laurel–
    Long term elevated insulin levels can be thought of as being ‘toxic’ to the lining of the blood vessels, including the ones that supply the heart: the coronary arteries.
    But I don’t think there are any short term, immediate toxic effects of insulin.  I would imagine that the sensation you are experiencing after a carb debauch is caused by one of two things: either your blood sugar is way up or your blood sugar is way down.  People with a tendency to insulin resistance develop insulin insensitivity first.  Their pancreases tend to have a blunted response to blood sugar.  The insulin they first secrete doesn’t bring down the sugar fast enough so the continue to secrete and end up over secreting and knocking the blood sugar too low. 
    Maybe you should talk to your physician about a glucose tolerance test.
    Best–
    MRE 

  20. Hmmm… perhaps we’re barking up the wrong tree. Of course Big Pharma isn’t going to help out. However, what about the people that are REALLY paying for all of these pills.
    I wonder if there would be a way to petition the insurance companies to support LC studies and testing. They could save a vast fortune if more of their members cured their symptoms with a healthy diet as opposed to paying large sums of money for different medications.
    Any ideas?
    Some insurance companies are looking into it, but so far they’re on the wrong track.  Dean Ornish has persuaded insurance companies to pay for people to go on his program of almost no fat by demonstrating that his program has been ‘proven’ to prevent and reverse heart disease.  No one, as far as I know, has made the same approach with the low-carb program.  When someone does, it will be a hard sell because the insurance companies are as wrapped up in fear of fat as most physicians.
    Cheers–
    MRE 

  21. My maternal grandfather was what is now known as a compounding pharmacist, one of the few educated people in my mother’s tiny town of 500 or so. There wasn’t always a doctor available, so people would go to him for medical help expecting some kind of chemical miracle from him. He would listen to their complaints, giving them the attention they would otherwise not get, both emotional and medical. Often, when the person was expecting to be given some medication, my grandfather would tell them, “The best medication is the one never taken,” and send them home. No placebos, no bromides.
    He took the obligations of his job seriously and ethically. What a change from what happens nowadays.
    Hi LC–
    Your grandfather was a wise man.  It’s a pity there aren’t more like him.

    Cheers–
    MRE 

  22. Hi Doc,
    Been away for a while and finally caught up with the blog reading. My new wife and I just got married in Iceland with the honeymoon in Wales the following week and a half. Thought I’d share a few funny tales. I have to admit we both were hard core low carbers but have somewhat fallen off the wagon. I blame Wales. We and two friends booked a biking (as in cycling…with our legs) trip around the southwest coast of Wales. Sounds great, right? The trip was marketed as flat terrain with rolling hills. I think the only flat terrain in Wales are the landing strips at the airports! We biked about 30 miles a day and I swear it was all uphill. It was literally like being at the gym for 6 hours a day doing slow burn on the legs. After the first day, with each pedal we were questioning our sanity. So, what does this have to do with low carbing? Well since none of us were Lance Armstrong we were having to output twice the effort to get anywhere so when we sat down to eat it was like watching ravenous vultures. I’ve never been so hungry or drained in all my life. Now, low carbing in Wales is about as practical as a screen door on a submarine. For God’s sake, they serve “chips” with EVERYTHING! And if you’d rather not have chips you have your choice of new potatoes, mashed potatoes, garlic potatoes, string potatoes, and my new favorite term “jacket potato” (baked) or you can get a small pathetic assortment of vegetables; read carrots, peas, broccoli…always in that order. After a while the waitresses started sounding like Bubba from Forrest Gump rattling on about shrimp, except with potatoes. Now, I could have just said bring me a plate of meat, but with everything being twice as expensive as it is here we would have been broke by the end of the trip. So needless to say in order to keep the caloric intake up I’ve probably eaten a sack and a half of potatoes in the last two weeks and I’ll have to admit quit a few desserts but hey, it’s vacation right? Another thing I thought was funny was that with dessert you have your choice of another dessert. They serve nearly every dessert with your choice of sweetened cream, ice cream or custard, for free. Couldn’t turn that down either. All in all it was great fun. Now I have to break my sugar habit again!
    Thanks for the great blog,
    Ned
    Hi Ned–
    Glad to have you back.  Funny story indeed.  Sounds like a great honeymoon: pedaling 30 miles per day uphill while eating potatoes and double desserts.  I can’t help but wonder if the 30 miles per day of uphill pedaling had any untoward effects on newlywed marital activities.
    Cheers–
    MRE 

  23. Dr. Eades, Thank you for keeping your eyes peeled for things like this. This supports my concept of people who low carb have a higher knowledge of what is substantially healthy for our bodies. Look at all the diseases that we avoid ( good thing cuz doctors give meds for everything ). I can get some pretty tasty low carb selections at many fast food places here. But, hey, this is CA and everyone has some kind of dietary agenda.That’s what keeps these places in business.;-) Again, thanks for the news.
    Mary Titus

  24. Hey Doc,
    Few things:
    1- By public good, I’m talking in economic terms, as in “consumption of the good by one individual does not reduce the amount of the good available for consumption by others; and no one can be effectively excluded from using that good.” I’m actually talking an extended definition that covers that the cost of the good is too great for any single provider to reap a reward. Like rural electrification, national defense, environmental clean up and firemen and cops. Almost by definition, government is better suited to deliver public goods than the market (I love trotting out the example of privatized fire departments of the 19th century). The debate is really whether public health is a public good or not. I’m in the camp that thinks it is. There’s a lot of room for debate, however.
    2- Recently read Beppe Severgnini’s Ciao America. He’s a Italian journalist who lived in DC for a year (he’s done it in other countries as well). He sums up the “American obsessions” thusly: Control, Comfort, Competition, community and Choreography. As far as a chemical/surgery interventive health system (rather than a cheaper preventive holistic system), it appeals to Control and Comfort (and competition too). Take two pills every day for the rest of your life and continue doing everything else the way you were doing it is all about control and comfort. Making changes (even simple ones like carb restriction) is not about comfort. It’s a little about control, but it’s about self control rather than control of the universe.
    Happy to be back. Catching up on the blog.
    Hi Max–
    As your catching up, don’t take all my rantings on gov’t employees to seriously.  I was in a state over the angst I was thrust into with my daughter-in-law’s passport misadventure and the gov’t incompetence that created the situation.
    Cheers–
    MRE 

  25. Marital activities?! Believe me there was no energy left- mental, physical or otherwise- at the end of the day. Besides, did I mention that sitting on a bike seat for 6 grueling hours a day makes one quite sore in the “marital activity” area?! We still wouldn’t have traded it for the world though.
    Cheers!
    I suppose planning a honeymoon biking in Wales is a good rationale for plenty of pre-marital activities.
    Cheers–
    MRE 

  26. Hey Doc!
    Great post as always. Ketones are also highly protective in cases of ischemic re-perfusion and hypoxia. For our Soldiers if a ketone ringer solution was used instead of a lactated ringers solution many of the fatal brain injuries could be avoided. More work from Veech and Seyfried.
    Thanks, Robb–
    And, according to Seyfreid, they work to treat brain cancer.
    Cheers–
    MRE 

  27. Doc,
    No worries.
    Pareto Curve is well in effect here at DOL with 80% sitting about and waiting for the great retirements. The weird thing is that just like the top 1% of earners (where 15-20% of people believe they’re in the top 1%), probably 60% of government workers think they are in the 20% that does 80% of the work. If you troll sites that appeal to government workers (GovExec.com or Fed-something-I-can’t-remember), you read a lot of comments from people who left government, tried their hand in the private sector and apparently couldn’t hack so they came back. I’m guessing they were in the 40% who are actually lousy but don’t know it.
    Any rate, I have my own passport story from 2004. Sent app in with 9 weeks to go before a trip to Asia, paid the expediting fee. In three weeks (not two), I got a form asking for 10 years of personal history. That took me two-three days to put together (it was twice as difficult as my background check for a public trust position, and 50% longer than my enhanced public trust). They took 4-5 weeks turning that around. I got my passport six days before leaving for Asia, and I still had to get a visa to go to Vietnam. Remarkably, the Vietnamese embassy was able to take a passport fed exed to them on Monday and Visa it and return it from New York to St. Louis by Thursday. Remarkable thing about communist countries… when the government wants something to get done, it seems to get done (I was in Vietnam during the Bird Flu thing… you couldn’t find a chicken ANYWHERE in Ho Chi Minh city… no restaurant, no street vendor, nothing).
    Any rate, you keep on knocking em, just remember there’s a useful 10% of us.
    Hey Max–
    I’m sure you’re in the useful 10% even though you wouldn’t have stopped for Jonathan Bell.  Thanks for not being offended by my government rants.
    Cheers–
    MRE 

  28. Great post, Dr. Mike! Loved it!
    As for Bi-polar disorder, I suffered from this horrific, torturous disorder for 13 years, on some dozen or more different medications, never being stable for more than 3 weeks at a stretch. I never stopped questioning my doctors as to WHY this couldn’t be controlled through non-drug means, always believing that I didn’t really suffer from a drug deficiency!
    Very long story short, I turned my nightmare around in less than a year, on my own, when I switched from a high carb vegetarian diet to a low carb, basically PPLP diet, adding a tablespoon of cod liver oil per day, and got off every single medication. I have taken NO medications, and had NO episodes in over 9 years now, despite having dealt with a difficult menopause, as well as some very trying personal life crises.
    I thank you and MD from the bottom of my heart, for showing me the path to save my health, and maybe even my life. My biggest sadness about all this is how frustrating it’s been trying to get friends and family to listen to me.
    Best,
    Madeline Mason
    Thanks for the kind words, Madeline.
    I’m glad you’ve done so well.
    MRE 

  29. Ugh, just reading these posts here makes me want to shout! Wake-up people. Stop consuming poison. To quote a famous speech, “I have a dream, today”, I will not go through any disease,ache, pain or even a hangnail without low carb.
    Mary

  30. If you should drop by this blog again, I have been pondering something and I wonder what you think about my pondering? My pondering is, is it at all possible that a ketogenic diet can benfit someone with dystonia. I just can’t stop thinking about this and I have yet to find any speculating on this. I am getting Dr. McCleary’s book. I might get 2 of them because I know someone who might benefit greatly from it. But I can’t help but to wonder how this would work for dystonia. I am hoping to attend a dystonia convention I would feel more comfortable if there were something there about the healing ability fo our ketogenic diet. Dr. Eades, you’d make a great speaker at this event. I’m just sayin’. 😉
    I think you ought to write Dr. McCleary through his blog. He’s a really nice guy and would be the one who would know.

  31. Thanks, I did write Dr. McCleary and he was very nice. He took the time to dig deep into my theory but could not any documentation on this subject. Thankfully he did suggest that this information should be taken to the acting physican or neurospecialist. I got some very positive feedback from him and I ordered his book. I received the wrong book, however ( The Brain That Changes Itself ) and will be exchanging it. Take care
    Mary

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