I’m Dr. Caroline Apovian–the medical nutrition expert for DASH for Health.   I bring over a decade of experience in helping people lose weight to the DASH diet program. I use the successes my patients have had to help the people using this system achieve healthy weight loss. You won’t find any claims here that weight loss is easy and effortless, but the DASH diet makes it simple. When you first log in, you will calculate how many calories you should be eating each day. From there, you will get access to your DASH eating plan. You can track your food intake, exercise and weight all in the DASH for Health system. Also, you can receive real-time progress reports that show you how you are doing.
Reynolds, AN. "Comment on 'An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals with Type 2 Diabetes: A Randomized Controlled Trial." Journal of Medical Internet Research. 2018; 20(5):e180, May 2018. Available at: http://www.jmir.org/2018/5/e180/  Accessed May 4, 2018.
It's important to note that the drop-out rate was substantial and reports of symptomatic hypoglycemia 1-5 episodes) were experienced by 69% of those in the study. The mean carbohydrate intake was 35 grams (+/- 15) daily. Based on self-reported results, the change in HbA1c was -1.45% (+/- 1.04, P < 0.001) with an average HbA1c of 7.2%  associated with greater hypoglycemia; yet, these results are comparable to other study findings. The average blood glucose levels were 104 mg/dL (+/- 16). 2  Final lipid profiles were mixed. The results were similar for adults and children.

The ketogenic diet seems straightforward. Unlike a typical low-calorie diet, however, a high-fat diet requires careful monitoring. In fact, you may start the diet in a hospital. Your doctor needs to monitor both blood glucose and ketone levels to make sure that the diet isn’t causing any adverse effects. Once your body adjusts to the diet, you may still need to see your doctor once or twice a month for testing and medication adjustments.
The Keto diet versus Plate Method study triggered some challenges and a bit of criticism. In an editorial, Andrew Reynolds, PhD, a postdoctoral research fellow at the University of Otago, New Zealand, suggests that the much better results in those on the ketogenic diet may be due not to the diet itself but to the lifestyle changes and ongoing support that keto diet group received.5

Here’s what we do know: The keto diet may be useful in treating symptoms of epilepsy, a seizure disorder. “The use of keto in treating epilepsy has the most evidence,” Angelone says. One study conducted by Johns Hopkins Medicine, for example, followed epileptic patients on the keto diet and found that 36 percent of them had a 50 percent reduction in seizures after three months on the diet, and 16 percent were seizure-free. However, experts aren't entirely sure why the keto diet has this affect, she adds.
After seeing thousands of patients now for years and from personal experience, I still believe it comes down to staying away from processed foods and cooking at home whenever possible. Eating a variety of fresh fruits, vegetables, proteins, and fiber. Also, cutting out any sugary liquid calories; staying away from sodas, juices and the infamous sweet tea! Keeping stress levels under control and incorporating exercise into your routine will also be key to breaking through challenging times when you are having trouble with continued weight loss.
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.
Some people on a keto or low carb diet choose to count total carbs instead of net carbs. This makes it more difficult to fit in more leafy greens and low carb vegetables (which are filled with fiber), so you should only try that if you don’t get results with a net carb method. And, start with reducing sugar alcohols and low carb treats before deciding to do a “total carbs” method.
The low glycaemic index treatment (LGIT)[48] is an attempt to achieve the stable blood glucose levels seen in children on the classic ketogenic diet while using a much less restrictive regimen. The hypothesis is that stable blood glucose may be one of the mechanisms of action involved in the ketogenic diet,[9] which occurs because the absorption of the limited carbohydrates is slowed by the high fat content.[5] Although it is also a high-fat diet (with approximately 60% calories from fat),[5] the LGIT allows more carbohydrate than either the classic ketogenic diet or the modified Atkins diet, approximately 40–60 g per day.[3] However, the types of carbohydrates consumed are restricted to those that have a glycaemic index lower than 50. Like the modified Atkins diet, the LGIT is initiated and maintained at outpatient clinics and does not require precise weighing of food or intensive dietitian support. Both are offered at most centres that run ketogenic diet programmes, and in some centres they are often the primary dietary therapy for adolescents.[9]
As for individuals with type 2 diabetes, Dr. Galati says, "a very low carbohydrate diet could be tolerated, albeit with extreme caution. Transitioning to a ketogenic diet will require several lifestyle changes as well as careful monitoring of both your food intake and glucose levels and adjustments to your medications. Also, you should increase your water consumption." 

3. Diabetes prevention. In a new Annals of Internal Medicine study, 215 type 2 diabetics were asked to follow either a low-fat or a Mediterranean diet. After four years only 44 percent of the Mediterranean group needed diabetes medication -- but 70 percent of the low-fat eaters did. The Med dieters also lost more weight. Other research shows that the diet helps people with pre-diabetes lower their blood sugar enough to avoid developing full-blown type 2 diabetes.
Meal planning also causes you to look at your calendar and consider everyones schedule. Grocery shopping can again become part of the family routine with everyone contributing to the meal. You’ll also notice a change in your weekly food budget. Susan pointed out that she had, “Given a presentation on the cost of buying food and cooking meals at home saved $1,200 a year versus eating out. Eating out on average costs people about $2,000 a year. Yes, there are some up front costs when buying the spices or equipment you may need but the second time you go to use them, you are saving instead of spending.”
What the expert says: ‘There have been a number of cases where GPs have said, “You’ve got IBS, go on the low-FODMAP diet”,’ says Dr Megan Rossi (@theguthealthdoctor). ‘The only support they give you is a printout with a limited explanation of the diet from the internet. I’ve had clients come into my practice who’ve been given a list of 10 “friendly” foods to survive on, which is nutritionally dangerous.’

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]
I started on a strict keto diet one year ago, and it has been the easiest diet I have ever been on. I was prediabetic before the diet, and now am not. My triglycerides are lower ( in normal range) and my good cholesterol is high. I am at lower than normal risk for heart disease because of my cholesterol ratios. I was not overweight to start with, am not now….and have not changed my weight at all. So the good effects are due solely to the diet change and not weight loss, which the author implies throughout the article that it is the weight loss that causes the good effects….not so. I am a veterinarian and believe in good medicine. This diet makes sense biochemically for those with diabetes or prediabetes.
To encourage ketone production, the amount of insulin in your bloodstream must be low. The lower your insulin, the higher your ketone production. And when you have a well-controlled, sufficiently large amount of ketones in your blood, it’s basically proof that your insulin is very low – and therefore, that you’re enjoying the maximum effect of your low-carbohydrate diet. That’s what’s called optimal ketosis.
Since avocados are packed with nutrients and healthy fats that can stimulate weight loss, it’s no surprise that avocado oil acts in a similar fashion. When Penn State University researchers compared those who consumed avocado oil with those who consumed a flax-safflower oil blend, they found that those who used just three tablespoons of avocado oil daily lost nearly two percent of their belly fat in just one month.
Body Fat Reduction. According to the current research literature, both visceral and subcutaneous fat play a role in the development of type 2 diabetes. [22] To keep our fat cells from fighting against us, we must adopt a healthier lifestyle that prevents us from being in a calorie surplus and gaining weight. The keto diet is one lifestyle change that has been proven time and time again to help us lose fat and improve metabolic health.  [24]

“Regardless of how solid they are, your diet and exercise plans won’t work if you aren’t sticking to them. You’ve made a commitment to yourself, so come through with it,” Roussell says. As you plan your meals or snacks, Roussell suggests putting an X over it on your menu map. If you skip a meal or eat something that isn't in your plan, circle that meal. At the end of each week, count the number of meals you ate according to your meal plan and divide that number by the total number of meals, snacks, and post-workout smoothies you had planned, then multiply it by 100.
“The alkaline diet often has a focus on eating lots of fresh produce and unprocessed foods, which could be a good thing,” says Hultin. “However, keep in mind that this is not an evidence-based therapeutic diet. When people take it too far — for instance, drinking baking soda — or become too restrictive or obsessive over food choices, it can definitely turn negative.”

I know a few people who struggle with keeping on the low carb diet and staying in ketosis. They introduced me to a exogenous drink called keto/os that is a natural energy drink that contains ketones. It gets you into ketosis within an hour!!! This can be tested in the blood and they showed me the results and it works!!! Not only that but it dropped their blood sugars as well. I am now on the product myself for other reasons but just thought I would share it. Let me know if you want more info.


There’s a large spectrum of where people can fall on a vegetarian diet: For example, vegans consume no animal products, whereas ovo-lacto vegetarians eat both dairy and eggs. The eating style may help with weight loss, suggests a review published in August 2017 in Nutrients, but some vegans and vegetarians may become deficient in specific nutrients, such as calcium, iron, zinc, and vitamin B12, according to an article published in December 2017 in Nutrition, Metabolism and Cardiovascular Diseases. (23,24)
The low glycaemic index treatment (LGIT)[48] is an attempt to achieve the stable blood glucose levels seen in children on the classic ketogenic diet while using a much less restrictive regimen. The hypothesis is that stable blood glucose may be one of the mechanisms of action involved in the ketogenic diet,[9] which occurs because the absorption of the limited carbohydrates is slowed by the high fat content.[5] Although it is also a high-fat diet (with approximately 60% calories from fat),[5] the LGIT allows more carbohydrate than either the classic ketogenic diet or the modified Atkins diet, approximately 40–60 g per day.[3] However, the types of carbohydrates consumed are restricted to those that have a glycaemic index lower than 50. Like the modified Atkins diet, the LGIT is initiated and maintained at outpatient clinics and does not require precise weighing of food or intensive dietitian support. Both are offered at most centres that run ketogenic diet programmes, and in some centres they are often the primary dietary therapy for adolescents.[9]

Our science-backed SmartPoints® system guides you to eat more fruits, veggies, and lean protein, while keeping track of foods with added sugar and unhealthy fats. Making smart decisions just got simpler, so you can live your best life. We meet you where you are— this plan works for men, brides, new moms, really anybody looking for inspiration to create healthier habits.
“It came to another frustration point that medication really isn’t helping,” Lofton says. “I had tried many other things, like a weight loss program. I tried looking into bariatric surgery, and was very frustrated that all these things — like watching my food intake and my servings, 60 grams (of carbs) per meal — all of that wasn’t really making a difference.”

During the 14 days of Phase 1, you will learn how to satisfy your hunger and, as a result, feel fuller longer. To regulate your blood sugar and help curb your cravings, avoid fruit and whole grains, which have a lot of natural sugar, and alcohol, which also contain sugars. That said, you can enjoy 2-3 servings of low-fat dairy per day. This would include 1 cup of skim milk or low-fat yogurt. Avoid regular or even fat-free cheese because they are often high in sodium.
Most people who want to lose weight have more than 12 pounds to lose. That’s why even the best weight loss drug in the world can only be an optional complement to other treatment. That’s why this piece of advice is number 18 out of 18. It may be a helpful addition for some people, but the advice higher on the list is what can make the biggest difference, by far.
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 eating plan has been proven to lower blood pressure in just 14 days, even without lowering sodium intake. Best response came in people whose blood pressure was only moderately high, including those with prehypertension. For people with more severe hypertension, who may not be able to eliminate medication, the DASH diet can help improve response to medication, and help lower blood pressure. The DASH diet can help lower cholesterol, and with weight loss and exercise, can reduce insulin resistance and reduce the risk of developing diabetes.
The Mediterranean Diet was identified in the 1960s as research continued to show populations from Mediterranean regions, particularly Southern Italy, the isle of Crete, and Greece, were considerably healthier, with less incidence of disease and longer lifespans than seen in other regions. Studies indicated that the way these populations ate seemed to be the common denominator and through research, the Mediterranean diet was formally born.
When it comes to condiments, mustard is about as healthy and low cal as it gets, and the pungent yellow stuff that contains about 5 calories per teaspoon has also been found to stimulate weight loss. Scientists at England’s Oxford Polytechnic Institute found that eating just one teaspoon of mustard can boost the metabolism by up to 25 percent for several hours after it’s been consumed. Researchers attribute this to capsaicin and allyl isothiocyanates, phytochemicals that give the mustard its characteristic flavor. So instead of reaching for the sickeningly sweet ketchup, make sure you have mustard on hand at your next BBQ.

A short-lived increase in seizure frequency may occur during illness or if ketone levels fluctuate. The diet may be modified if seizure frequency remains high, or the child is losing weight.[18] Loss of seizure-control may come from unexpected sources. Even "sugar-free" food can contain carbohydrates such as maltodextrin, sorbitol, starch and fructose. The sorbitol content of suntan lotion and other skincare products may be high enough for some to be absorbed through the skin and thus negate ketosis.[30]
Where is the science? And if insolin intolerance is a diabetic problem why keep trying to regulate insolin? The stuff isn’t working because your patients are not getting better just deteriorating slower while you make more money keeping them on drugs!!!!! Your hole point is ketosis is bad cause they don’t have to see you after they adjust off the medication that keeps them having to see people like you!!! I have been eating keto for 6 months and feel amazing!!! These people are twisting the truth to keep you sick for there own pockets!!!!!!

It appears that a ketogenic diet is generally safe when implemented correctly. One must be careful to obtain all the necessary nutrients by eating a variety of foods, such as non-starchy vegetables, seeds, and nuts, and also consume adequate protein and essential fatty acids. Provided that the need for vitamins, minerals, amino acids and fatty acids is met, there is no reason to suspect that the ketogenic diet is unsafe.

A systematic review in 2016 found and analysed seven randomized controlled trials of ketogenic diet in children and young people with epilepsy.[2] The trials were done among children and young people for whom drugs failed to control their seizures, and only one of the trials compared a group assigned to ketogenic diet with a group not assigned to one.[16] The other trials compared types of diets or ways of introducing them to make them more tolerable.[2] Nearly 40% of the children and young people had half or fewer seizures with the diet compared with the group not assigned to the diet. Only about 10% were still on the diet after a few years.[2] Adverse effects such as hunger and loss of energy in that trial were common, with about 30% experiencing constipation.[16]

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.
Adherence to the DASH-style pattern may also help prevent the development of diabetes, as analyzed in a recent meta-analysis, and kidney disease as found in the Atherosclerosis Risk in Communities (ARIC) cohort that followed more than 3700 people who developed kidney disease. [8, 9] Dietary components of DASH that were protective in the ARIC cohort included a high intake of nuts, legumes, and low-fat dairy products. A high intake of red meat and processed meats increased kidney disease risk.
There’s a large spectrum of where people can fall on a vegetarian diet: For example, vegans consume no animal products, whereas ovo-lacto vegetarians eat both dairy and eggs. The eating style may help with weight loss, suggests a review published in August 2017 in Nutrients, but some vegans and vegetarians may become deficient in specific nutrients, such as calcium, iron, zinc, and vitamin B12, according to an article published in December 2017 in Nutrition, Metabolism and Cardiovascular Diseases. (23,24)
Other down sides: There’s an initial period where your body is adjusting to its new carb-free existence, and many people experience symptoms like fatigue, brain fog and nausea for a few weeks. You also end up deficient in important micronutrients, like folate, calcium and potassium, which is why most ketogenic devotees recommend taking multivitamins. Personally, I recommend my clients follow a diet that in its ideal state provides all of the nutrients you need through real, whole foods.
I started on a strict keto diet one year ago, and it has been the easiest diet I have ever been on. I was prediabetic before the diet, and now am not. My triglycerides are lower ( in normal range) and my good cholesterol is high. I am at lower than normal risk for heart disease because of my cholesterol ratios. I was not overweight to start with, am not now….and have not changed my weight at all. So the good effects are due solely to the diet change and not weight loss, which the author implies throughout the article that it is the weight loss that causes the good effects….not so. I am a veterinarian and believe in good medicine. This diet makes sense biochemically for those with diabetes or prediabetes.
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.
Fish and seafood come next, eaten about twice a week. Poultry, eggs and dairy in the form of cheese and yogurt are eaten in moderate portions on a daily or weekly basis. For example, one review of research on Mediterranean eating suggests about four eggs a week. At the very top of the pyramid -- meaning you eat them only sparingly -- are red meat and sweets. Preferred beverages include water, as well as red wine, in moderation.
Are you trying to shed those extra kilos? The ketogenic diet is a low carb diet, moderate in protein and high in healthy fats. The primary goal of the ketogenic diet is weight loss. The diet helps to bring your body into a metabolic state which is known as the ketosis. Ketosis occurs when the body has run out of its glycogen (which is basically sugar) stores so it needs to find another source of fuel. When this occurs your liver begins to process fat into ketones which become the body's main fuel source. Some of the foods that one can enjoy on a keto diet are avocado, cheese, sour cream, Greek yoghurt, chicken, fatty fish and full-fat milk. Just like every coin has two sides, in the similar way every diet has some pros and cons. The following article will explore some of the advantages and disadvantages of this fad diet, keto diet.
The classic ketogenic diet is not a balanced diet and only contains tiny portions of fresh fruit and vegetables, fortified cereals and calcium-rich foods. In particular, the B vitamins, calcium and vitamin D must be artificially supplemented. This is achieved by taking two sugar-free supplements designed for the patient's age: a multivitamin with minerals and calcium with vitamin D.[3] A typical day of food for a child on a 4:1 ratio, 1,500 kcal (6,300 kJ) ketogenic diet comprises:[27]

This high-fat, adequate-protein, low-carb fad diet sends the body into a state of ketosis, in which the body uses stored fat for energy. Research published in Clinical Cardiology suggests the ketogenic, or “keto,” diet can be an effective weight loss method, but to be successful, you must follow the plan consistently with no cheat days — otherwise, you’re just eating a high-fat diet that may be high in unhealthy fats for no reason. (1) (A pro tip? If you're planning on doing the diet, consider perusing this complete keto food list and reading up on the healthiest fats for keto diet followers.)
Pros: Technically a subtype of low-carb diet, the keto diet is unique: By depriving your body of carbohydrates, you not only force your body to become fat-adapted, but also, if you keep protein low as well, elevate your levels of ketone bodies, which is basically a sign your body is running on fat. The keto diet puts you in a unique metabolic state called ketosis wherein your brain burns ketones instead of glucose—and, in doing so, supposedly leads to clearer thinking. Physically, eating such a high amount of fat significantly increases your body’s ability to burn body fat, according to the study analysis. Research also shows keto athletes have a higher VO2 max, and are able to lose fat without losing strength or power.
Also recognizing what worked 6 months to 1 year ago may not work today. Our bodies change over time and we have to adapt to those changes. So many factors affect your blood glucose levels; you will face hormonal changes, stress related changes, and your pancreas may not be working as well today as it did a year ago and we wouldn’t expect it to. Just as the heart of an 18 year old person is much stronger than it will be at the age of 50 years of age, your pancreas’ function will decline with age with the normal aging process. Many of my patients throughout the years have came to me feeling so defeated because now they have to go on medication or insulin. They are so relieved to hear this may not be due to anything they have caused by overeating or weight gain, it may be just the unfortunate natural progression of diabetes. Until we discover cures for the different types of diabetes, this is what we face.
Not to be outdone, oolong tea—a Chinese beverage—can help those who drink it shed up to a pound per week. According to a study in the Chinese Journal of Integrative Medicine, participants who regularly sipped oolong tea lost six pounds over the course of six weeks. What’s more? The tea’s antioxidants are thought to remove harmful free radicals and improve bone health.
The ketogenic diet may offer hope to people with type 2 diabetes who have difficulty controlling their symptoms. Not only do many people feel better with fewer diabetic symptoms, but they may also be less dependent on medications. Still, not everyone has success on this diet. Some may find the restrictions too difficult to follow over the long term. Yo-yo dieting can be dangerous for diabetes, so you should only start the ketogenic diet if you’re sure you can commit to it. A plant-based diet may be more beneficial for you both short- and long-term, so input from your dietitian and doctor can help guide your diet choice.

Drink lots of water. This is especially crucial on a low carb or keto diet. Why? When you eat carbohydrates, your body stores the extra as glycogen in the liver, where they are bound to water molecules. Eating low carb depletes this glycogen, which allows you to burn fat – but it also means you are storing less water, making it easier to get dehydrated. Instead of the traditional recommendation of 8 cups of water per day, aim for 16 cups when following a low carb lifestyle.
People claiming huge benefits of these supplements – despite the lack of solid scientific support – may sometimes have a financial reason to believe in the supplements. Some of these products are sold under a multi-level marketing arrangement, where sales people are paid based on commission. For example, the company Prüvit sells drinkable ketones, called KETO//OS with a multi-level marketing structure.
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