I am in the uk and a diagnosed t2d. I am also a nurse, although I am in end of life care. Up until my diagnosis I am ashamed to say the I believed in exactly th.e same things as the writer of this article. Our health service actively promotes a carb rich diet for t2d. Not an excessive amount of calories, but a “healthy” amount of whole grains, fruit, whole rice etc. It was not until I did some actual research and looked at the science that I came to see that what I had been taught and what I really did believe to be the best advice was quite simply wrong.
“Intermittent fasting can be really challenging if you have an ever-changing schedule,” adds Hultin. “If you're traveling and crossing time zones, it could be very difficult to follow. It might be best for people with more stability in their lives.” Intermittent fasting isn’t safe for people with type 2 diabetes, children, pregnant or lactating women, or anyone with a history of an eating disorder.

But the DASH Diet isn’t a magic solution if you’re looking for quick weight loss. “I do think that if people follow this diet, there can be healthy weight loss,” says Srinath, “but weight loss is also tied to calorie restriction.” If you’re looking to drop, say, 20 pounds, you’ll have to consume fewer calories in addition to hitting the recommended serving amounts. Still, if you currently follow a pretty junky diet, you could easily wind up cutting the necessary calories with DASH, she explains.

This was simply the best response to this article. The doctor who wrote it has no idea of the life changing benefits of keto. Bravo to you for speaking up. Congratulations on reversing your diabetes. I dont have diabetes and am not obese but I switched to keto to live a longer healthier life. I’ve never felt better. Must mention that I am 32. I want to prevent disease. Let the food be the medicine.
Christopher D. Gardner, PhD; Alexandre Kiazand, MD; Sofiya Alhassan, PhD; Soowon Kim, PhD; Randall S. Stafford, MD, PhD; Raymond R. Balise, PhD; Helena C. Kraemer, PhD; Abby C. King, PhD, “Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women,” JAMA. 2007;297(9):969-977. http://jama.jamanetwork.com/art icle.aspx?articleid=205916.
Several comprehensive studies and meta-analyses have demonstrated that after a few months or even a year of a low carb diet versus a moderate/high carb diet, there are no significant differences in the amount of weight lost (2,3,4,5).  I will say, however, most of these diets are NOT keto and are simply lower carb (i.e. 20%).  Also, long-term effects (beyond 1 year) are not often studied due to budgetary constraints, so interpret results as you wish.
A survey of 1,580 low-carb consumers published in late 2017 by the Journal of Insulin Resistance45 found that while more than 11% of respondents reported using sleep-aids before beginning their low-carb diet, less than 5% reported using them after their diet. Moreover, nearly seven in 10 reported improved quality of sleep after dieting while only 3.4% said their sleep quality had worsened.
On day 1, have a cup of plain low-fat Greek yogurt for breakfast, topped with 1/2 cup of blueberries and an ounce of chopped walnuts. The yogurt gives you calcium and satisfying protein, while the berries are full of antioxidants that protect you against cellular damage, and the nuts supply heart-healthy omega-3 fats. Have yogurt on day 4, too, but try pomegranate seeds and chopped pistachios -- or sliced oranges and chopped almonds.

The DASH diet is an acronym for Dietary Approaches to Stop Hypertension. As you can probably guess, this eating plan was originally developed to help people lower their blood pressure. But it can do a whole lot more than that: The DASH diet has been shown to reduce bad cholesterol and improve insulin sensitivity. Studies have also suggested that following a DASH diet plan can reduce the risk of serious health issues such as stroke, kidney stones, and diabetes. It's no wonder why so many doctors recommend the DASH diet to their patients and why the plan has been ranked as the "best overall diet" by US News & World Reports for eight years in a row.
A small Feb. 20, 2017, study looked at the impact of a six-week ketogenic diet on physical fitness and body composition in 42 healthy adults. The study, published in the journal Nutrition & Metabolism, found a mildly negative impact on physical performance in terms of endurance capacity, peak power and faster exhaustion. Overall, researchers concluded, “Our findings lead us to assume that a [ketogenic diet] does not impact physical fitness in a clinically relevant manner that would impair activities of daily living and aerobic training.” The “significant” weight loss of about 4.4 pounds, on average, did not affect muscle mass or function.

Eating low-carb paleo means removing items like rice, pasta, and legumes from your diet completely, but the carbs you eat will be from vegetables like fruit, beets, sweet potatoes, and leafy greens, such as spinach and kale. The diet also cuts out processed food plus foods allowed on other low-carb diets, including milk and cheese, and some people have an easier time sticking with the diet when more carbs are included.
“I’m no longer on insulin, and I have cut down my medications due to keto. I never had to deal with trying to find a spot to inject or having to deal with bruises on my belly,” she says. “I know this may sound silly, but I have a picture of my old insulin syringes in my wallet. I look at it to remind me of what I had to do before keto. It grounds me, and when I have days of self-doubt, I remind myself how far I’ve come.”

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Sodium reduction is part of the DASH equation, but it’s not the only focus. Eating by DASH  recommendations also increases your intake of potassium, calcium, magnesium and fiber—all nutrients that play a role in cardiovascular health, as well as the prevention of other chronic diseases. It’s thought to be the combination of increasing your intake of these nutrients and decreasing your intake of added sugar, salt, sodium and unhealthy fats that leads to lower blood pressure and a laundry list of other long-term health benefits.
This is a helpful article. But there are some inaccurate things too. I have type two diabetes and use a keto genie diet to lose weight (45# so far). I was able to get my cholesterol down, Triggs down, and my A1C to 6! I went off and followed a Mediterranean diet for a year. I gained back 15# and my diabetes got worse. So I am back on keto. I am using a closer to Mediterranean keto both then and now.
If you are pregnant or are nursing, you should not follow a Ketogenic diet. You will not receive enough of the recommended carbohydrates, vitamins and nutrients necessary for yourself and your growing baby on this diet. Your obstetrician will recommend how many carbohydrates you should consume per meal and for snacks during each phase of your pregnancy. They will likely refer you to a Certified Diabetes Educator for nutritional counseling as well. Please check out The Diabetes Council’s FAQ’ About Gestational Diabetes for all your gestational diabetes related questions.
A relatively new offering, the Nutritarian diet is based on maximizing the amount of healthy vitamins, minerals, and trace nutrients in your food, balancing your hormones, and avoiding toxins. The plan—created by Joel Fuhrman, M.D., author of The End of Dieting—is nutrient-dense, plant-rich, and includes anti-cancer superfoods to help you not just lose weight but live a long, disease-free life. (P.S. Follow these guidelines to make sure you're absorbing all the nutrients from your food.)
I have patients that have lost tons of weight on keto. They do go off some meds. I also have people who eat a moderate amount of good carbohydrates, and they have lost tons of weight, and been taken off meds, had improved markers, even reversal. I think both approaches work, as I have seen in practice. Many people cannot stay on a keto diet forever. I for one, prefer to have some carbohydrates. I try to pick the right ones. If this works for you, then just be sure to have some medical supervision, which it sounds as though you are doing.
While body weight decreased significantly (-8.5 kg) in these 21 diabetic participants, the mean weight loss was less compared with what we observed in the LCKD participants of an earlier trial (-12.0 kg) [18]. Given that the diabetic participants had a higher baseline mean weight than the LCKD participants of our previous trial (131 kg vs. 97 kg), this translates into an even more dramatic disparity in percent change in body weight (-6.6% vs. -12.9%). This lesser weight loss might result from several factors. First, in the current study, most of the participants were taking insulin and/or oral hypoglycemic agents that are known to induce weight gain[20,21] Second, these same agents, particularly insulin, inhibit ketosis, which is strived for in the earliest phases of the LCKD; while it remains unclear whether ketones actually play a role in weight loss on the LCKD, previous research in non-diabetic patients has shown a positive correlation between level of ketonuria and weight loss success [22]. Lastly, compared with our previous study the participants in the current study had more comorbid illness, lower socioeconomic status, and a shorter duration of follow-up (16 weeks versus 24 weeks), all of which are associated with reduced success on any weight loss program [23].

The DASH Diet, which stands for dietary approaches to stop hypertension, is promoted by the National Heart, Lung, and Blood Institute to do exactly that: stop (or prevent) hypertension, aka high blood pressure. It emphasizes the foods you've always been told to eat (fruits, veggies, whole grains, lean protein and low-fat dairy), which are high in blood pressure-deflating nutrients like potassium, calcium, protein and fiber. DASH also discourages foods that are high in saturated fat, such as fatty meats, full-fat dairy foods and tropical oils, as well as sugar-sweetened beverages and sweets. Following DASH also means capping sodium at 2,300 milligrams a day, which followers will eventually lower to about 1,500 milligrams. DASH Diet is balanced and can be followed long term, which is a key reason nutrition experts rank it as U.S. News’ Best Overall Diet, tied with the Mediterranean Diet.
And, it's important to recognize that both study teams acknowledge that as exciting as their findings seem, a large, randomized controlled trial is still needed to more closely assess a variety of components that may be contributing to the successes found in both studies before the findings can be recommended to anyone outside the study groups1,2  he says.
Your body uses the carbohydrates you eat for energy, so if we restrict how many carbohydrates we eat, the body has to get its fuel source from fat. A byproduct of this fat burning state are ketones which are produced; this is called nutritional ketosis. You can determine if you are in this fat burning state by purchasing urine ketone testing strips from your local pharmacy.
The primary outcome, hemoglobin A1c, decreased from 7.5 ± 1.4% at baseline to 6.3 ± 1.0% at week 16 (p < 0.001), a 1.2% absolute decrease and a 16% relative decrease (Table ​(Table4).4). All but two participants (n = 19 or 90%) had a decrease in hemoglobin A1c (Figure ​(Figure1).1). The absolute decrease in hemoglobin A1c was at least 1.0% in 11 (52%) participants. The relative decrease in hemoglobin A1c from baseline was greater than 10% in 14 (67%) participants, and greater than 20% in 6 (29%) participants. In regression analyses, the change in hemoglobin A1c was not predicted by the change in body weight, waist circumference, or percent body fat at 16 weeks (all p > 0.05).
The Dietary Approaches to Stop Hypertension, or DASH, diet has been consistently ranked by US News & World Report as a top diet for heart health and weight loss, and it’s no surprise why. Unlike fad diets that call for extreme calorie or food-group restrictions without scientific evidence that supports their efficacy, the DASH diet involves making manageable dietary changes that are flexible and rooted in proven nutritional advice.
Despite the promising evidence, we must remain skeptical. A few studies can only provide us with clues as to what might be the better dietary intervention for people with type 2 diabetes. To find out if carb restriction can take the throne as the most effective type 2 diabetes diet, we must look at the bigger picture of the data with the help of high-quality meta-analyses.

The DASH diet plan focus on increasing vegetables, fruits, whole grains, and legumes; choosing lean meats, low-fat dairy, nuts and healthy fats; and limiting added sugars, trans fats, added salt, and processed foods. Serving sizes from each food group are based on individual calorie needs (see below for a 1600-calorie plan), and you’ll likely find that the plan looks pretty close to the MyPlate plan, as well as another consistently rated “top diet,” the Mediterranean Diet. Here’s a breakdown of the recommended nutrients in a typical day and week on the DASH diet:
The Mediterranean diet is most famous for its benefit to heart health, decreasing the risk of heart disease by, in part, lowering levels of “bad” LDL cholesterol, and reducing mortality from cardiovascular conditions. It’s also been credited with a lower likelihood of certain cancers, like breast cancer, as well as conditions like Parkinson’s disease and Alzheimer’s disease. (1)
In September 2018, researchers at Harokopio University in Athens released a study that suggests adhering to the Mediterranean diet can promote better sleep, specifically in older adults. While more research needs to be conducted to determine exactly how and why the Mediterranean diet improves sleep quality, senior study author Dr Mary Yannokoulia suggested that the connection could have to do with the presence of the sleep-promoting hormone melatonin in foods like olive oil, fish and fruit.
But beyond that, experts aren't convinced that the keto diet has any other scientifically-proven health benefits. In fact, it may have some distinct downsides. If you follow the keto diet incorrectly, for example (like by eating lots of saturated fats, versus healthy unsaturated fats), you're at risk of raising your cholesterol levels. “The best strategy to keep your heart healthy is to get as much fat as possible from unsaturated sources such as olive, avocado and canola oils, nuts, seeds, avocados, and olives," says Ansel.
Cheese isn’t traditionally thought of as something you consume to encourage weight management, but calcium-rich Parmesan, when eaten in moderation, can help stave off sugar cravings that can easily lead to weight gain. How does that work, you ask? The native Italian cheese contains the amino acid tyrosine (a building block of protein) which has been shown to encourage the brain to release dopamine without any unhealthy insulin spikes. What’s more? The combination of calcium and protein found in dairy products such as Parmesan has been found to increase thermogenesis—the body’s core temperature—and thus boost your metabolism.
Normal dietary fat contains mostly long-chain triglycerides (LCT). Medium-chain triglycerides are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate,[3] leading to more food choices and larger portion sizes.[4] The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil.[15] Consuming that quantity of MCT oil caused abdominal cramps, diarrhoea and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant.[9] The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.[3]
What the expert says: ‘Over 50 years ago researchers realised they didn’t have to restrict energy every day and they still got a protective effect. In animals, these diets were shown to reduce visceral fat, oxidative stress and reduce cell proliferation, which is involved with the development of cancer. The models that were used in humans were two consecutive days of 650kcal then five days following a normal, healthy diet, versus a healthy med diet of 1500kcal.

Hi Cyn, The numbers are general guidelines but will vary depending on many factors, such as activity level, insulin resistance, weight and more. There is no single magic number, just conventional recommendations that are a good starting point. I will have a macro calculator coming soon that will help determine what is best for each person, but even then it’s an approximation. The only way to know for sure is to test. If keto is your goal, it’s usually best to start lower and then see if you can stay in ketosis when increasing.


Diabetes is one of the most common chronic diseases in the world. In 2014, diabetes affected about 387 million people worldwide and resulted in $612 billion dollars of health-related costs. [5] Unfortunately, as a conventional western lifestyle of poor nutrition and exercise habits becomes more popular, diabetes is expected to affect about 592 million people worldwide. [6] In the United States alone, diabetes increased from 5.58 diagnosed cases in 1980 to 22.3 million diagnose cases in 2013. [7]
The only books based on the most recent updated Mediterranean and DASH research, include the brand new, high flavor and high impact The DASH Diet Mediterranean Solution and the previous best seller The DASH Diet Weight Loss Solution, both of which can help you harness the health benefits of the DASH diet for weight loss. The DASH Diet Younger You, is pumped up on plants to help you become and look younger from the inside out. It fully supports both vegetarians and meat eaters (as does the Med-DASH book), with meal plans and recipes, and are based on real, unprocessed, and additive-free foods. The essential companion, The Everyday DASH Diet Cookbook will make a great addition to your kitchen collection. These books stand alongside the top DASH diet resource, The DASH Diet Action Plan, to give you a fresh start to healthy eating.
According to the Mayo Clinic, the DASH diet calls for eating lots of fresh veggies and fruits, but it requires consuming only a moderate amount of whole grains, as well as lean sources of protein and healthy fats, such as fish and nuts, respectively. (6) This distinguishes the DASH Diet from other popular plans, such as the Atkins diet and the ketogenic diet, or the high-fat, low-carb diet.
I was diagnosed in 2004 with Brittle Type 1 diabetes, peripheral and autonomic neuropathy, and Hypothyroidism. A short time later with Gastroparesis due to the nerve damage from diabetes. Since then, I had followed every guideline and rule that the Endocrinologist and Primary Care Doctors had told me to follow. NOTHING WAS GETTING BETTER. In fact, I was gradually getting worse. So many ups and downs. Extreme highs (250-500 bgl ) to seizures from crashes (drop from 300 to 13 in no time). It was a constant battle with adjustments in insulin intake (and different insulins NPH, R, Novolog, Humalog, Lantus), carb intake, exercise and one contributing factor was the Gastroparesis. Meds were taken for the Gastroparesis but I always had side effects from meds. To my point. I was kicking a dead horse and I told them this. My sister and mom had come across the ketogenic way of eating and it dramatically improved thier lives. Mom was diagnosed way back with Type 2 and within a week or two she was off of her meds completely. I was totally interested. So, I decided to go for it on April 17, 2017. I did go through some rough patches of what they call Keto Flu. It did pass after a couple weeks. I was gaining so much energy like never before as well as mental focus. The even greater aspect of this all was, I had DRAMATICALLY LOWERED MY INSULIN INTAKE TO ALMOST NONE! My Lantus was always being adjusted from 30-40 units daily (and changed from AM to PM to splitting it to half AM, other half PM). I was on a sliding scale of Humalog or Novolog. From 4-6 units per meal and then there were the corrections throughout my day (some daily totals could be up to 40 UNITS)! Very exciting for me to only take 2 units of Lantus in the AM and daily totals of Humalog/Novolog….1.5-3 units! Other great things I began to notice, neuropathy pains were fading and finally GONE. No more nights up stinging, burning and RLS (restless leg syndrome). So, in my life, there are no questions or hardships on whether I can get off of this way of eating. It’s either do or die. If someone truly wants to have a better life, they can. The sad thing is, doctors and nutritionists aren’t being educated in the real facts. My primary care doctor isn’t willing to help me with all the labs I need nor listen. Always telling me “You need carbohydrates and insulin to live.” All that know me see the dramatic change for the better. I’m doing the Ketogenic way of eating with intermittent fasting for the rest of my life. The alternative IS NOT WORTH a lifetime of illnesses and suffering.

Yes, you can eat dark chocolate to lose weight. A study among women with normal weight obesity (or “skinny fat syndrome”) who ate a Mediterranean diet that included two servings of dark chocolate per day showed a substantial reduction in waist size than when on a cocoa-free meal plan. Researchers attribute dark chocolate’s weight loss abilities to flavonoids, heart-healthy compounds in the sweet treat that the scientists at Harvard say can reduce the risk of diabetes, heart disease, and mortality. Like nuts, dark chocolate has also been found to induce satiety. When reaching for chocolate, just make sure you choose a bar with at least 70 percent cacao. Anything less contains more belly-bloating sugar and a significantly reduced flavonoid content.

The problem is: it flies in the face of the way we have been taught. Our society (as an American), and our medical community, have preached for years that FAT is bad, and you should limit it. However, recent FACTS beg to differ. So many people rail against the keto diet because they just feel that it can’t be good…after all, you eat so much fat on it, it can’t be good for you! Facts are facts…they don’t care about your feelings. Fat is not the enemy. Sugar is.
In the first week, many people report headaches, mental fogginess, dizziness, and aggravation. Most of the time, this is the result of your electrolytes being flushed out, as ketosis has a diuretic effect. Make sure you drink plenty of water and keep your sodium intake up.6One of the fathers of keto, Dr. Phinney, shows that electrolyte levels (especially sodium) can become unbalanced with low carb intake.
If the diet is a quick fix rather than one that promotes lasting lifestyle changes, this could pose a problem. In particular, extreme diets that promise big weight loss up front aren’t always sustainable — and you may end up overeating or even binge eating if you feel deprived. “Consider if the diet’s habits are ones you can continue throughout your lifetime, not just 21 or 30 days,” says Angie Asche, RD, a sports dietitian in Lincoln, Nebraska.
What the expert says: ‘Over 50 years ago researchers realised they didn’t have to restrict energy every day and they still got a protective effect. In animals, these diets were shown to reduce visceral fat, oxidative stress and reduce cell proliferation, which is involved with the development of cancer. The models that were used in humans were two consecutive days of 650kcal then five days following a normal, healthy diet, versus a healthy med diet of 1500kcal.
The brain is composed of a network of neurons that transmit signals by propagating nerve impulses. The propagation of this impulse from one neuron to another is typically controlled by neurotransmitters, though there are also electrical pathways between some neurons. Neurotransmitters can inhibit impulse firing (primarily done by γ-aminobutyric acid, or GABA) or they can excite the neuron into firing (primarily done by glutamate). A neuron that releases inhibitory neurotransmitters from its terminals is called an inhibitory neuron, while one that releases excitatory neurotransmitters is an excitatory neuron. When the normal balance between inhibition and excitation is significantly disrupted in all or part of the brain, a seizure can occur. The GABA system is an important target for anticonvulsant drugs, since seizures may be discouraged by increasing GABA synthesis, decreasing its breakdown, or enhancing its effect on neurons.[7]
WY conceived, designed, and coordinated the study; participated in data collection; performed statistical analysis; and drafted the manuscript. MF assisted with study design, performed data collection, and helped to draft the manuscript. AC analyzed the food records. MV assisted with study/intervention design and safety monitoring. EW participated in the conception and design of the study, and assisted with the statistical analysis. All authors read and approved the final manuscript.

A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed; 24% occasionally prescribed the diet as a last resort; 24% had only prescribed the diet in a few rare cases; and 16% had never prescribed the diet. There are several possible explanations for this gap between evidence and clinical practice.[33] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[30]


Calcium and vitamin C team up well to boost metabolism, and broccoli is just one of several healthy foods that contain both nutrients. What sets broccoli apart from the others, however, is that the green veggie also contains kind of fiber that’s been shown to increase the digestion, absorption and storage of food, also known as the thermic effect of food or TEF. A revved up metabolism combined with an increased TEF is a match made in weight loss heaven!
First reported in 2003, the idea of using a form of the Atkins diet to treat epilepsy came about after parents and patients discovered that the induction phase of the Atkins diet controlled seizures. The ketogenic diet team at Johns Hopkins Hospital modified the Atkins diet by removing the aim of achieving weight loss, extending the induction phase indefinitely, and specifically encouraging fat consumption. Compared with the ketogenic diet, the modified Atkins diet (MAD) places no limit on calories or protein, and the lower overall ketogenic ratio (approximately 1:1) does not need to be consistently maintained by all meals of the day. The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet. Carbohydrates are initially limited to 10 g per day in children or 20 g per day in adults, and are increased to 20–30 g per day after a month or so, depending on the effect on seizure control or tolerance of the restrictions. Like the ketogenic diet, the MAD requires vitamin and mineral supplements and children are carefully and periodically monitored at outpatient clinics.[47]
The popular low-carb diets (such as Atkins or Paleo) modify a true keto diet. But they come with the same risks if you overdo it on fats and proteins and lay off the carbs. So why do people follow the diets? "They're everywhere, and people hear anecdotally that they work," McManus says. Theories about short-term low-carb diet success include lower appetite because fat burns slower than carbs. "But again, we don't know about the long term," she says. "And eating a restrictive diet, no matter what the plan, is difficult to sustain. Once you resume a normal diet, the weight will likely return."
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