The sad truth is that conventional ideas – eat less, run more – do not work long term. Counting calories, exercising for hours every day and trying to ignore your hunger? That’s needless suffering and it wastes your time and precious willpower. It’s weight loss for masochists. Eventually almost everyone gives up. That’s why we have an obesity epidemic. Fortunately there’s a better way.
The comments defending the keto diet suggest that the individuals are successfully using the keto diet to help them maintain a healthy weight and a healthier A1C level. The individuals also suggest that they view it as a way of life rather than a diet. This is good news for many of us who are facing the question of whether it will be helpful and necessary to reduce carbohydrate intake to keto producing levels in order to halt or reverse the onset of type II diabetes. I think like those individuals, Tami is speaking from her own personal experience where she had success losing weight, but had difficulty maintaining the keto diet long-term. I am sure that though you have been successful, you can understand that there are many who might find it difficult to maintain. I too have been given very bad guidance by Medical Doctors who lean on old Med School information to practice medicine rather than continuing to broaden their knowledge base and learn more about nutrition. I cannot get back the 20+ years of suffering with a debilitating disease that could have been cured because my doctors were not well informed or willing to listen to information that disagreed with their limited knowledge base. Those years are gone and the destruction to my body is not reversible. So I understand the anger you feel toward a system that isn’t working in the best interest of the patient. But I think that expressing anger toward those who disagree with our personal experience, is not solving the problem. Hopefully we can change the ADA guidelines by respectfully urging them to reconsider their position based on the sheer volume of the comments they receive from successful people like you, who are living the keto diet lifestyle and living better. I commend you for becoming your own best health advocates. Thanks for your encouragement and your passion. And thanks to Tami as well for sharing her personal experience and the information she had collected. We all have to be true to what we believe and we all have a right to come to our own conclusions. It is good to know that there are success stories out there. I wish you all good health and continued success. I also hope that one day medical training will do a much better job of preparing doctors to become their patient’s best advocates, actively learning and searching for cures rather than treating symptoms in ways that cause even more disease to develop. The system is failing so many of us.

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.
Elena Paravantes, RDN is a Registered Dietitian Nutritionist, Writer and consultant specializing in the Greek Mediterranean Diet and Cuisine. She has been active as a clinician, consultant and lecturer for 20 years, both in the U.S. and Greece. An expert on the Greek Mediterranean Diet, her interviews and articles have been published in many publications including CNN, U.S. News and World Report, Prevention, NPR, and Shape. Elena has collaborated with a number of organizations including Loyola University, Yale University, University of Missouri, Louisiana State University, and the American College of Greece.

Spirulina is a high-protein seaweed supplement that’s typically dried and sold in powdered form. The dried stuff is about 60 percent protein, and, like quinoa, it’s a complete protein, meaning it can be converted directly into muscle in the body and is thus a great weight loss tool. A tablespoon of the blue-green algae delivers 8 grams of metabolism-boosting protein for just 43 calories, plus half a day’s allotment of vitamin B12, which in and of itself can give you more energy and boost your metabolism. Try tossing some spirulina into a smoothie and watching the pounds melt off. For more skinny smoothie ideas, check out this list of 56 Smoothies for Weight Loss!

Make sure that the diet has been studied extensively for safety — and discuss any changes with your physician or registered dietitian before beginning a new diet. (If you don’t have a dietitian, find one in your area at the Academy of Nutrition and Dietetics website.) And do a self-check to ensure the diet fits with your own values and preferences.


Those issues can be part of what's known as the “keto flu,” Warren says. Other side effects of the keto diet, all of which are tied to carb withdrawal, can include lightheadedness, nausea, mental fog, cramps, and headaches, in addition to tiredness. Luckily, the keto flu doesn't usually last more than a week—which is coincidentally about when people start to see the number on the scale go down, says Warren.
“I think the caution with a low-carbohydrate diet is the idea that it’s very restrictive,” Zeratsky says. “When you start getting into the very low carbohydrates, when you’re talking about 20 grams, which for some people would be a cup of [starchy] vegetables. … If there is someone who is interested in it, it’s very important they understand what a low carbohydrate diet means in a practical sense.”
Although some studies have indicated that a ketogenic diet is associated with dyslipidemia (cholesterol and triglyceride perturbations), many of these results were obtained from studies on rodents and did not always agree with what the data show in human studies. A recent review summarized the controversy, highlighting the discrepancies in the literature. In part, the discordance is likely due to the exact composition of the diet, specific study design, as well as the metabolic differences between rodents and humans.
You’re transitioning. Your body is equipped to process a high intake of carbs and a lower intake of fat. Your body needs to create enzymes to be able to do this. In the transitional period, the brain may run low on energy which can lead to grogginess, nausea, and headaches. If you’re having a large problem with this, you can choose to reduce carb intake gradually.

Close the Kitchen at Night. Establish a time when you will stop eating so you won't give in to the late-night munchies or mindless snacking while watching television. "Have a cup of tea, suck on a piece of hard candy or enjoy a small bowl of light ice cream or frozen yogurt if you want something sweet after dinner, but then brush your teeth so you will be less likely to eat or drink anything else," suggests Elaine Magee, MPH, RD, WebMD's "Recipe Doctor" and the author of Comfort Food Makeovers.
I see several inconsistencies, one being a strict 20 grams or less of carbs, most Keto followers I see aim for closer to 30, and even as high as 40 per day. I also see several times in this article her opinion that you cannot get all of your essential vitamins and minerals without eating fruits, and I’m no nutritionist, but this is far from the truth. The writers hatred for this w.o.e. Presents itself early and often in this article, and because they weren’t able to successfully stay away from sweets, and other carbs, they’re attempting to scare others away as well, especially pregnant women. She admits that she’s been taught to follow the ADA’s dietary guidelines which has been proven to fail. It sadly isn’t working. She recommends consulting your physician before attempting this w.o.e., I tried that and was instructed to follow the clean eating that I had followed for the first 15 years with type 1. The 60 grams of complex carbs in meals, and 20 or so with snacks. That way allowed me to ride a dangerous daily rollercoaster, with damaging highs, and very dangerous lows. Yet my Endo was pleased with my sub 7 a1c, even though I was always tired. I’ve practiced a very healthy way of eating long before being dxd with type 1, which probably makes it easier for me to continue living this way. Ultimately, the info is out there, and those able to avoid certain foods will be rewarded with non diabetic numbers… some say big food/pharmaceutical are doing all they can to end this “fad” I’m not sure if it’s true or not, but the simple fact that there will always be those that lack enough discipline to remain in ketosis should still present them with enough clientele.

A small, randomized crossover study published in the Journal of Diabetes Sciences and Technology found that after three months, people who followed a modified, low-carb paleo diet saw greater reductions in their A1C, their triglycerides, their diastolic blood pressure, and their weight than those who followed a traditional diabetes diet. (The approach also increased their levels of LDL, or "good” cholesterol.) The diabetes diet in the study involved consuming no more than 6 g of salt per day, reducing saturated fat and total fat intake, and upping intake of veggies, fiber, whole grains, fruits, and veggies. Compared with the diabetes diet, the paleo diet involved eating less dairy, beans, potatoes, and cereals, and more veggies, fruit, meat, and eggs.
Beans can help boost feelings of fullness and manage blood sugar levels, making them an excellent ally in your weight loss battle. In fact, a recent study published in The American Journal of Clinical Nutrition found eating one serving a day of beans, peas, chickpeas or lentils could contribute to modest weight loss. And if you need another reason to bulk up on beans, remember that the fiber and protein-rich legumes are other excellent sources of genistein—the same compound found in peanuts and lentils that aids weight loss.
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.
In summary, the LCKD had positive effects on body weight, waist measurement, serum triglycerides, and glycemic control in a cohort of 21 participants with type 2 diabetes. Most impressive is that improvement in hemoglobin A1c was observed despite a small sample size and short duration of follow-up, and this improvement in glycemic control occurred while diabetes medications were reduced substantially in many participants. Future research must further examine the optimal medication adjustments, particularly for diabetes and diuretic agents, in order to avoid possible complications of hypoglycemia and dehydration. Because the LCKD can be very effective at lowering blood glucose, patients on diabetes medication who use this diet should be under close medical supervision or capable of adjusting their medication.
A study in the journal Metabolism found that eating half a grapefruit before meals may help reduce visceral fat and lower cholesterol levels. Participants in the 6-week study who ate a Rio Red grapefruit fifteen minutes before each meal saw their waists shrink by up to an inch, and LDL levels drop by 18 points. Though researchers don’t exactly know what makes grapefruit so good at burning fat, they attribute the effects to a combination of phytochemicals and vitamin C found in the tart treat.

“A lot of people think the foundation of a paleo diet is high-fat meat, but I suggest that it’s vegetables,” says Hultin. The concept is to eat only foods — including meat, fish, poultry, eggs, fruits, and vegetables — that would have been available to our Paleolithic ancestors. This means grains, dairy, legumes, added sugar, and salt are all no-no’s.

To follow the plan, one must decide their calorie level and then divide the suggested servings of each food group throughout the day. This requires meal planning ahead of time. The NHLBI guide provides many tips on how to incorporate DASH foods and to lower sodium intake; a one-day sample menu following a 2300 mg sodium restriction and a 1500 mg sodium restriction; and one week’s worth of recipes. The NHLBI also publishes an online database of “heart healthy” recipes.
The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[18] On admission, only calorie- and caffeine-free fluids[36] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[18]
I think what bothered me most about the article was the way in which the writer has put her own fears about living without cake onto the shoulders of any diabetic she might treat. In the same way an epileptic might choose a life without cake in order to remain seizure free I choose a life without cake to remain “undiabetic”. I must admit that when I was researching this diet I did worry that I would not have the stamina, but the thought of going blind is a useful motivator.
Think of each almond as a natural weight-loss pill. A study of overweight and obese adults found that, combined with a calorie-restricted diet, consuming a little more than a quarter cup of the nuts can decrease weight more effectively than a snack comprised of complex carbohydrates and safflower oil—after just two weeks! (And after 24 weeks, those who ate the nuts experienced a 62% greater reduction in weight and BMI!) For optimal results, eat your daily serving before you hit the gym. A study printed in The Journal of the International Society of Sports Nutrition found that almonds, rich in the amino acid L-arginine, can actually help you burn more fat and carbs during workouts. Fill up, but don’t fill out: Use these Eat This, Not That!-recommended 10 Daily Habits That Blast Belly Fat.
A: You’ll find a detailed menu earlier in this article (also, recipes from Everyday Health!), but generally, you’ll want to make plants and whole grains the stars of your plate. If you look at a Mediterranean diet food pyramid, sweets are up top (indicating they should make up only a small part of your diet), followed by meat and dairy, and then fish. Last are fruit, veggies, and whole grains (suggesting they can be eaten liberally). Also, enjoying food with friends and family is a tenet of the eating approach, so make your meals a social affair!
Kamut is an ancient grain native to the Middle East that is an excellent source of heart-healthy omega-3 fatty acids, protein, and fiber, while simultaneously being low in calories. In fact, a half-cup serving of the stuff has 30 percent more protein than regular wheat and just 140 calories. What’s more? A study published in the European Journal of Clinical Nutrition found that eating Kamut reduces cholesterol, blood sugar, and cytokines (which cause inflammation throughout the body). Kamut’s ability to stabilize blood sugar and reduce inflammation make it a great weight loss staple, especially if it is used in place of nutritionally lacking refined grains.
Thank you SO much for this! My husband approached me about the Mediterranean diet being good for depression and suggested I give it a try. But I already knew this was not the best term to describe what I needed, even before reading your article on the subject. However, I did have an idea of what they meant and I have struggled to find recipes that fit the bill. Too many well-meaning people have made it more “healthful” by cutting back on the fat. ANYWAY . . . This little meal plan is going to be immensely helpful to me and I am poking all around the site and your social media. Thank you for sharing!
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.
Insulin is a hormone that lets your body use or store sugar as fuel. Ketogenic diets make you burn through this fuel quickly, so you don’t need to store it. This means your body needs -- and makes -- less insulin. Those lower levels may help protect you against some kinds of cancer or even slow the growth of cancer cells. More research is needed on this, though.
Also, if you listen to Dr Bernstein talk about his childhood (he is well into his 80’s), the “original” recommended diet was only ketogenic in the sense that it was high-carb and caused keto-acidosis, which he describes as almost killing him as a teenager. He still considers the ADA recommendations as ketogenic for this reason (you only have to listen to him a short time to hear him railing against the ADA).
A study published in the journal Nutrition & Metabolism discouraged the Atkins diet for anyone with diabetes because the plan doesn’t limit fat, but noted the approach may be a safe way for people without the disease to lose weight effectively. According to a study published in the Journal of the American Medical Association, Dr. Atkins helped women lose weight better than other low-carb diets, such as the Zone diet, the Ornish diet, and the LEARN diet after 12 months.
He has been on keto diet for at least 3 years now. I think that he is some proof that yes, it does work. And it may be that some people do need keto. However, I don’t believe that everyone needs keto diet to get reversal. I have had reversal with regular ADA diet in my clinic. Not just a few! Many have reversed. However, I just want for keto dieters to find a clinical trial. We do need more information. We must understand what happens in the long term on keto diet. I personally did Atkins years ago, which was 20 grams. I had a very hard time to stay on it. I lost 20 pounds, and then I did gain it back. I just could not live without some more carbohydrates than this allowed. I don’t know about being on 60 to 70 carbs, and staying in ketosis. It seemed I was out of it at 22 carbs. Anyway, this was not for me. Maybe it is for you. No one is saying that one should never go on a keto diet, but we are wary of it. We need more science behind it. Therefore, I am just going to put this out here now. I will paste it down the page so that others may see it. They are taking participants. If you fit the criteria, please help us to get more than people’s opinion about this diet. Then we can be more positive about it, and recommend it if the science is there. Here is the link to the clinical trial. Thanks for your comments:

Though the ketogenic diet is quite safe and even beneficial for diabetics, there is sometimes a chance a patient can develop diabetic ketoacidosis. Anytime you change your body’s primary energy source from carbohydrates to fat, your blood becomes flush with those ketones we talked about. And, anytime there are too many ketones, there is a potential risk for developing ketoacidosis. However, this is most likely to occur in those with type 1 diabetes. It can still happen in individuals with type 2 diabetes, although is it quite rare.

Make sure that the diet has been studied extensively for safety — and discuss any changes with your physician or registered dietitian before beginning a new diet. (If you don’t have a dietitian, find one in your area at the Academy of Nutrition and Dietetics website.) And do a self-check to ensure the diet fits with your own values and preferences.


The risks are more long term, such as risk of nutritional deficiency (vitamin c, a, k and b vitamins) and also increased risk of bowel and possibly breast cancer cancer due to limited fibre intake. Ketosis generally isn’t recommended and it’s not exactly a state that would the body would usually be in, but it can be done safely for set periods of time.’
During the 1920s and 1930s, when the only anticonvulsant drugs were the sedative bromides (discovered 1857) and phenobarbital (1912), the ketogenic diet was widely used and studied. This changed in 1938 when H. Houston Merritt, Jr. and Tracy Putnam discovered phenytoin (Dilantin), and the focus of research shifted to discovering new drugs. With the introduction of sodium valproate in the 1970s, drugs were available to neurologists that were effective across a broad range of epileptic syndromes and seizure types. The use of the ketogenic diet, by this time restricted to difficult cases such as Lennox–Gastaut syndrome, declined further.[10]
Incidentally , there’s a very informative article on the bbc website about one of the last remaining hunter/gather societies left in the world, living in Tanzania. They have amazing gut health and no t2d. Would you like to guess at the type of diet they follow? This would be the caveman diet that the writer mentions, and yes these people might not live as long as us but the cause of death is never a lack of motivation to stay on a keto diet.
The improvement in glycemic control occurred while medications for diabetes were discontinued or reduced in most participants (Table ​(Table5).5). During the study, hypertension and hyperlipidemia medication doses were not increased from baseline nor were new agents added, except in 3 individuals. No serious adverse effects related to the diet occurred. One participant had a hypoglycemic episode requiring assistance from emergency services after he skipped a meal but the episode was aborted without need for transportation to the emergency room or hospitalization.

The overall goal of the DASH Diet — short for Dietary Approaches to Stop Hypertension — is to lower your consumption of sodium, which aids in lowering your blood pressure. Since the diet focuses on eating the right foods with the right portions, it's also effective for short- and long-term weight loss. Find out more about the DASH Diet and if it's right for you.


In nature, historically, there were very few ways to store carbs – which were available only for a short time seasonally. The solution to this is that when eating the available fruit in the autumn the sugars switch off the fat burning system and then use insulin to store the sugars as body fat. Carbs signal our body to go into fat storage mode. When the carbs run out then slowly the fat burning more resumes – first of all feeding ketones to the brain and other vital organs and then eventually to the muscles.
The ketogenic diet has been studied in at least 14 rodent animal models of seizures. It is protective in many of these models and has a different protection profile than any known anticonvulsant. Conversely, fenofibrate, not used clinically as an antiepileptic, exhibits experimental anticonvulsant properties in adult rats comparable to the ketogenic diet.[57] This, together with studies showing its efficacy in patients who have failed to achieve seizure control on half a dozen drugs, suggests a unique mechanism of action.[55]
2- Eat more vegetables, fruits, grains, and legumes. The base of the Mediterranean diet pyramid should make up the base of every meal. When you can, opt for vegetarian entrees like this Cauliflower and Chickpea Stew;  Spicy Spinach and Lentil Soup; or Spanakopita (Greek Spinach Pie). Rely more on satisfying, flavor-packed salads to make up a good portion of your plate. Some ideas: Kindey Bean Salad; Mediterranean Chickpea Salad; Greek Salad; Bean and Lentil Salad.
There are three instances where there’s research to back up a ketogenic diet, including to help control type 2 diabetes, as part of epilepsy treatment, or for weight loss, says Mattinson. “In terms of diabetes, there is some promising research showing that the ketogenic diet may improve glycemic control. It may cause a reduction in A1C — a key test for diabetes that measures a person’s average blood sugar control over two to three months — something that may help you reduce medication use,” she says.
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