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Ketogenic

The Science of Therapeutic Carbohydrate Restriction in Human Health

1st Edition - June 22, 2023

Editors: Tim Noakes, Tamzyn Murphy, Neville Wellington, Hassina Kajee, Jayne Bullen, Sarah Rice, Candice Egnos

Paperback ISBN:

9 7 8 - 0 - 1 2 - 8 2 1 6 1 7 - 0

eBook ISBN:

9 7 8 - 0 - 1 2 - 8 2 1 6 2 3 - 1

Ketogenic: The Science of Therapeutic Carbohydrate Restriction in Human Health presents the most up-to-date and evidence-based science and research available in the field of TCR,… Read more

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Ketogenic: The Science of Therapeutic Carbohydrate Restriction in Human Health presents the most up-to-date and evidence-based science and research available in the field of TCR, with the purpose of training medical and allied healthcare professionals on the effective therapeutic use of low-carbohydrate and ketogenic nutrition in clinical practice. This book explores the appropriate, safe, and effective use of TCR to improve patient outcomes in a broad range of chronic metabolic conditions and aims to promote health.

Focused on lifestyle management, health support and the treatment of diseases rooted in poor nutrition, this book explores the role of food and lifestyle modification as medicine and is a valuable resource for nutritionists, dietitians and medical professionals who provide diet-related counselling, as well as those researching or studying related areas.

Cover image
Title page
Table of Contents
Copyright
List of contributors
Preface
Introduction
Part 1: Nutritional fundamentals
Chapter 1. Understanding human diet, disease, and insulin resistance: scientific and evolutionary perspectives
Abstract
1.1 Understanding human diet and disease – the scientific and evolutionary evidence
1.2 Insulin resistance: a unifying feature of chronic disease
1.3 The adoption and evolution of dietary guidelines
References
Chapter 2. Nutritional aspects
Abstract
2.1 Introduction
2.2 Therapeutic carbohydrate restricted dietary intervention
2.3 Physiological ketosis of the Fed State: biochemical and nutritional aspects
2.4 Implications for nutrient needs
2.5 Plant versus animal nutrition
2.6 Conclusion
References
Further reading
Part 2: Medical nutritional therapy
Chapter 3. Endocrine
Abstract
3.1 Introduction
3.2 Liver
3.3 Metabolic syndrome
3.4 Type 2 diabetes
3.5 Adapting medication for type 2 diabetes in the context of therapeutic carbohydrate restriction
3.6 Type 1 diabetes
3.7 Polycystic ovarian syndrome and infertility
3.8 Body weight
3.9 Thyroid health and insulin resistance
3.10 Adrenals and the hypothalamic-pituitary-adrenal (HPA) axis
References
Chapter 4. Cardiovascular disease and its association with insulin resistance and cholesterol
Abstract
4.1 Anatomy and normal physiology of the cardiovascular system
4.2 Cardiovascular pathophysiology
4.3 Cholesterol
4.4 Lipoproteins
4.5 Carbohydrate restricted diets and specific cardiac disorders
4.6 Conclusion
References
Chapter 5. Neurology
Abstract
5.1 A ketogenic diet addresses the pathophysiology underlying diverse neurological disorders
5.2 Neurophysiology and energy metabolism
5.3 Cerebrovascular disease and stroke
5.4 Epilepsy
5.5 Alzheimer’s disease
5.6 The ketogenic diet in mood disorders
5.7 Multiple sclerosis and nutrition
5.8 Parkinson’s disease
5.9 Neurodevelopment and autism spectrum disorder
5.10 Migraine
5.11 Amyotrophic lateral sclerosis
5.12 Traumatic brain injury
Useful websites
References
Chapter 6. Cancer
Abstract
6.1 Cancer as a modern disease
6.2 Cancer as a mitochondrial metabolic disease
6.3 Cancer management using press-pulse ketogenic metabolic therapy
6.4 Implementation of modifiable ketogenic diets in cancer
6.5 Fasting and chemotherapy
References
Further Reading
Chapter 7. Musculoskeletal and immunological considerations
Abstract
7.1 Introduction
7.2 Musculoskeletal conditions
7.3 Gout
7.4 Ageing and therapeutic carbohydrate restriction
7.5 Autoimmunity
7.6 Perspective: autoimmunity in the context of plant and animal nutrition
References
Further reading
Chapter 8. Gastrointestinal health and therapeutic carbohydrate restriction
Abstract
8.1 Introduction
8.2 The human digestive system in health and disease
8.3 Diet and gastrointestinal disorders
8.4 The Microbiome and Therapeutic Carbohydrate Restriction
References
Part 3: Therapeutic carbohydrate restriction for health and fitness
Chapter 9. Exercise and sports performance
Abstract
9.1 Introduction
9.2 The science of low carbohydrate and ketogenic diets for exercise and sports performance
9.3 Practical application of low-carbohydrate high fat diet and ketogenic diets in athletes
9.4 Evidence that the oxidation of liver- (or gut-) derived glucose, but not muscle glycogen, is obligatory for sustained exercise performance in humans
9.5 Nutritional supplementation for athletic performance
9.6 Case study
References
Chapter 10. Therapeutic fasting
Abstract
10.1 Introduction
10.2 Physiology
10.3 Therapeutic fasting
10.4 Conclusion
References
Further reading
Part 4: Managing the patient
Chapter 11. Psychological, behavioural, and ethical considerations
Abstract
11.1 Introduction
11.2 Behaviour change
11.3 Eating control
11.4 Legal and ethical aspects to therapeutic carbohydrate restriction
References
Further reading
Acronyms
Index

Tim Noakes

Professor Tim Noakes is the author or co-author of more than 550 scientific publications and is on the Editorial Boards of more than 10 international scientific publications. Professor Noakes has been cited more than 16 000 times in the scientific literature, has an H index of 68 and is rated an A1 scientist by the National Research Foundation of South Africa. His latest book, Lore of Nutrition, published in 2017, explains the science behind the low-carb, high-fat/Banting diet, and why he champions this lifestyle despite the constant persecution and efforts to silence him. He also discusses at length what he has come to see as a medical and scientific code of silence that discourages anyone in the profession from speaking out against the current dietary guidelines.

Affiliations and expertise

Author or co-author of more than 550 scientific publications and is on the Editorial Boards of more than 10 international scientific publications

Tamzyn Murphy

Tamzyn Murphy is a registered dietitian with an MSc (Med) Physiology (Dist.) degree investigating Low Carbohydrate High Fat (LCHF) diets in Type 2 Diabetes. Currently Tamzyn works as a lecturer, course developer, and content writer for Nutrition Network, an online LCHF training platform for healthcare professionals. Tamzyn is co-founder and practicing dietitian at Real Food Dietitians – a practice which focuses on low carbohydrate approaches to treat metabolic diseases. Previously, Tamzyn spent 6 years as Nutrition Editor and writer at Health Intelligence magazine, while working in the supplement industry in training and nutritional supplement research and development. Tamzyn is co-author of the Sugar Free book (2015), writes online articles and conducts print, online, television and radio interviews. After qualifying as a dietitian in 2009, Tamzyn worked in poor South African communities, which sparked her passion for understanding nutrition’s role in the rising epidemics of obesity and related metabolic diseases.

Affiliations and expertise

Lecturer, course developer, and content writer for Nutrition Network; Co-founder and Practicing Dietitian, Real Food Dietitians

Neville Wellington

Dr Neville Wellington is a GP and managing practitioner at Kenilworth Medicross. He has been working in medicine for over 21 years, with paediatrics and diabetes among his main passions. He completed a two-year Postgraduate Diploma in Diabetes in 2012 and now runs a Centre for Diabetes and Endocrinology (CDE), overseeing 13 doctors, a diabetes educator and a dietician. Neville is a staunch advocate of a low-carb lifestyle. Dr Wellington received a MBChB from the University of Cape Town in 1990, DCH (SA) in 1993, and PGDD from Cardiff University in 2012.

Affiliations and expertise

GP and Managing Practitioner, Kenilworth Medicross, Glosderry, South Africa

Hassina Kajee

Dr Hassina Kajee is a board member and Medical Director of the Nutrition Network. Dr Kajee is a Specialist Physician, Registrar of Internal Medicine and Undergraduate Course Convener and Lecturer for medical students. Dr Kajee was a Senior Medical Officer in the high care unit of a tertiary level hospital in South Africa for a number of years and ran an obesity clinic. She has a very strong interest in preventative medicine and educating and empowering patients with regards to a disease-specific lifestyle. She has a special interest in and knowledge about low carbohydrate high fat diets and actively employs these principles both at home and in her practice.

Affiliations and expertise

Board Member and Medical Director, Nutrition Network, Noordhoek, South Africa

Jayne Bullen

Jayne believes research in healthcare needs better funding and strong minds. As the Chief Operating Officer of The Noakes Foundation, she established Eat Better South Africa alongside inspiring colleagues and Prof Noakes and believes in building stronger collaboration in the nutrition and science game. After realizing the dichotomy between brand research budgets and human health research, she decided to leave the formal research world, committed to bringing her global experience in big biz research, systems, and policy change expertise into new areas to affect change to human health. Jayne is an MBA Chevening Scholar, High Dip in Marketing and International Relations graduate. In her MBA at Leeds University, she focused on the regulation of marketing to children in the food and fast food categories, later conducting Pan European media research and strategy evaluation in this area for various global health bodies and brands. As an extension of her collaborative vision for the future of human health and better healthcare systems, she co-founded Nutrition Network and has been its Managing Director since it was founded in 2018.

Affiliations and expertise

Nutrition Network Managing Director; Chief Operating Officer, The Noakes Foundation, South Africa

Sarah Rice

Sarah Rice qualified in the U.K as an optometrist with a BSc. (Hons) MCOptom degree and worked in private practice and NHS hospital eye service. Having developed an interest in therapeutic carbohydrate restriction her current focus is on researching and curating references and other resources that support clinicians' use of this approach in the support of metabolic health and disease management. She researched and curated the references for the Nutrition Network reference resource which she updates monthly. Sarah is an accredited member of the Society of Metabolic Health Practitioners and a certified Nutrition Network Medical Practitioner.

Affiliations and expertise

Nutrition Network Medical Practitioner, South Africa

Candice Egnos

Candice is a Bachelor of Laws and Bachelor of Social Sciences UCT graduate, but her true passion lies in all things health and nutrition-related. She is a keen foodie and is knowledgeable about the TCR / Keto environment. Candice was The Noakes Foundations Communications Executive for three years and is now the Project Director of the Nutrition Network. She is thrilled to be a part of a team that is changing the way people around the world think about food and nutrition.

Affiliations and expertise

Nutrition Network Project Director, South Africa