You’ve enjoyed hearty eating during the 28 days of your meal plan, but you may need an occasional snack to get you through a long afternoon of work or school. Choose an ounce of nuts or dried apricots; a cup of low-fat cottage cheese sprinkled with black pepper and a dash of salt; or an ounce of herbed goat cheese with a handful of whole-grain crackers. If you need something sweet after dinner, have a piece of fruit or 1/2 cup of fresh-fruit sorbet.
What the diet guru says: ‘Every phase of the New Atkins plan is based on proven scientific principles and is a completely safe, natural way to lose weight,’ say Akins Nutritionals Inc. ‘Phase one is about transforming your body into a fat burning machine and kickstarting your weight loss. By limiting the amount of carbs you eat to around 20g a day, your body will switch its main fuel source from carbs to fat.’
However, the meta-analysis was riddled with confounding variables — one of which being their lackadaisical definition of a low-carb diet. The researchers identified a low-carb diet as a diet where less than 45% of its calories come from carbs. With such a lax criterion for low-carb, it is difficult to tell if a true low-carb diet (i.e., fewer than 26% of calories coming from carbs) is genuinely the best dietary option for type 2 diabetics.
The ketogenic diet tries to bring carbohydrates down to less than 5 percent of a person’s daily caloric intake – which means eliminating most grains, fruit, starchy vegetables, legumes and sweets. Instead, it replaces those calories with fat. That fat is turned into ketone bodies, which are an alternative energy source: besides glucose derived from carbohydrates, ketones from fat are the only fuel the brain can use.
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.
Roussell explains that when we get too hungry, our bodies secrete a hormone called, ghrelin, which controls our hunger and appetite. If too much ghrelin is released, we get hangry and will grab pretty much anything. Before bed, however, Roussell says going to sleep a bit hungry can actually be beneficial. “Going to be hungry may actually help you sleep better as ghrelin makes your body more responsive to compounds in your brain that aid in sleep.”
You are so biased against Keto, this can be noticed very quickly because almost every positive thing you say about Keto, you immediately follow with a “but…” negative statement. And most of your negatives are simply saying it’s hard to maintain. You completely exaggerate the negatives “If you have one bad day and your body is kicked out of Ketosis, you immediately gain all of your weight back”. That is simply not true; if someone is on a Keto diet for 3 months, they will not gain that weight back in a day. Also, their body will be back into Ketosis the next morning. You say that the ADA doesn’t recommend 60-70 grams per meal, but it does (coincidentally I just left their website before coming here). I don’t claim to be a Diabetes expert; I admit that. But your bias is leaning heavily against Keto. “Moderation” is not your goal if you have diabetes. When you compare HbA1C levels, for example, you compare them with someone in Keto at less than 20 g of Carbs per day as compared to someone at a 70-90 gram of carbs per day diet. You should be fair and compare them with someone on a 200 g of Carbs diet. If you want to get rid of the effects of Diabetes, get on a Keto Diet, period. It MAY get rid of the effects completely, but in the very least it WILL reduce your Insulin needs to very low and you’ll have little-to-no side effects other than a relatively restrictive diet (most diets are WAY more restrictive than Keto). You back up everything with “science” and misleading numbers/arguments without providing any real evidence.
There isn't "a" Mediterranean diet. Greeks eat differently from Italians, who eat differently from the French and Spanish. But they share many of the same principles. Working with the Harvard School of Public Health, Oldways, a nonprofit food think tank in Boston, developed a consumer-friendly Mediterranean diet pyramid that offers guidelines on how to fill your plate – and maybe wineglass – the Mediterranean way.
I am a big fan of the ketogenic diet and many of my patients have had huge success on it. Having said that, it’s not necessarily for everyone. This should be looked at as a long-term strategy, not a short one. Some people simply find the dietary restrictions too difficult to commit to. Since yo-yo dieting is bad for everyone, and can be downright dangerous for diabetics, you should only begin the ketogenic diet if you feel you can stick to it.
You may have noticed a bit of an explosion of gluten-free offerings on your grocery store shelves. Some may call it a trend, but over the last 70 years there’s been a steady increase in the number of people who don’t tolerate gluten or other grain proteins. People with a sensitivity, intolerance or full-on Celiac disease experience any combination of brain fog, inflammation, fatigue, joint pain, and gut issues – and they tend to resolve simply by avoiding grains.
I can tell how passionate you are about this subject. As you can see on one of my reply’s above, CDE’s do not recommend the same number of carbs for every person we see; we use an individualized approach. It varies depending on the person’s height, bone structure/muscle mass, amount of weight they may need to lose (or gain) and the amount of exercise they may or may not do per day/week.
The good news here is no! All the evidence points to the fact that a low carbohydrate diet actually does lower blood glucose and A1c levels and does contribute to weight loss. The problem is we do not yet have enough large studies, over enough sustained years to support evidence that people with diabetes can remain on a highly restrictive Ketogenic Diet for the rest of their life and also not have other consequences to their health.
In the short term, you may lose a modest amount of weight over a year span and are likely to keep it off it you continue to eat following the diet. (6) If eating in the Mediterranean style prompts you to consume more fruits and vegetables, you’ll not only feel better physically, but your mental health will get a lift, too. Research shows that people who eat more raw fruits and veggies (particularly dark leafy greens like spinach, fresh berries, and cucumber) have fewer symptoms of depression, a better mood, and more life satisfaction. (36)
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.)
Grains and beans are some of the most carbohydrate-dense foods out there, so breads, rice, and beans will spike your blood sugar causing crashes and cravings later on. There’s more to the issue with grains and beans, though. They contain some proteins and compounds that humans just don’t handle well. Here’s a breakdown of some of the issues with grains and beans.
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.
The first meta-analysis worth noting collected the data from 10 randomized trials comprising 1376 participants in total.  After analyzing the research, a key relationship emerged between dietary carbs and blood sugar levels. In short, the researchers described their finding thus: “the greater the carbohydrate restriction, the greater glucose lowering…” 
Ketoacidosis (KA) is a life-threatening condition in which your body doesn’t make enough insulin. This causes you to have dangerously high levels of ketones (substances occurring when the body uses fat stores for energy) and blood sugar. The combination of both makes your blood incredibly acidic, and this can, in turn, change the normal functioning of your internal organs such as your liver and kidneys. Patients suffering from ketoacidosis must get treatment immediately or they could slip into a coma and even die.
“We have basically no evidence that this diet is consistent with human health over time,” says Dr. Katz. (Its heavy emphasis on animal protein isn’t ecologically sustainable, either, he adds.) “All of the evidence we have points toward a plant-predominant diet with an emphasis on vegetables, whole grains, fruits, nuts, and seeds—all of the very things that the ketogenic diet avoids.”
Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose). Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.
As far as weight loss is concerned, I have heard great things from many who have switched to eating the Mediterranean way. Some were able to see results in just a few weeks…feeling better and losing a moderate amount of weight. From my personal experience, the only time I wasn’t eating the Mediterranean way was during my early years in college. I attended college in Michigan, and naturally, I ate whatever was available in the school cafeteria. Freshmen year, I gained nearly 30 lb. But lost it all without much effort in 2 months, when I returned home that summer and started to eat Mediterranean again. It’s important to say that the Mediterranean lifestyle is really a way of living, and one we commit to longer term, not necessarily a quick diet for the sake of losing weight. I always mention too that I have no medical or professional background to lend in the area of weight loss. If that is priority, a registered dietitian or someone with that kind of experience would be of help.
As far as the the Ketogenic Diet goes, it is a very personal decision between you and hopefully your physician. I would just recommend working closely with your physician for all the recommended lab tests to make sure you remain healthy while on the diet. That’s really the goal of any “diet” anyway, right? To get healthy? This is why we normally always recommend moderation with everything…moderation in the foods you eat along with moderate amounts of exercise equals a healthy lifestyle that will prevent diabetes or help you control your diabetes if you already have it.
More good news: Snacks are totally allowed (and I'm not just talking about carrot sticks). There are plenty of packaged options out there designed for keto fans. FATBAR is one of them. These snack bars have 200 calories, 16 grams of fat, and four grams of net carbs. They're also plant-based and are made with almond or cashew butter, cocoa butter, coconut, pea protein, sunflower seeds, and chia seeds.
The DASH (Dietary Approaches to Stop Hypertension) diet is sometimes prescribed by doctors to help treat high blood pressure. Blood pressure is the amount of pressure that blood places against the walls of arteries. It will normally vary throughout the day but if it remains too high, this is called high blood pressure or hypertension. Untreated high blood pressure can lead to heart disease, stroke, congestive heart failure, kidney disease, and blindness. 
This research found the weight loss was slightly greater in the group fasting for two days compared to the other group. It’s worth noting that the participants in these studies were given a huge amount of support, which wouldn’t happen if you were just picking up a book on the 5:2 diet. Overall, there isn’t actually much evidence and we need more data on the long-term success of these diets.’
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.
One review, published in April 2016 in The American Journal of Medicine, looked at five research trials on overweight and obese people and found that after one year those who followed a Mediterranean diet lost as much as 11 pounds (lbs) more than low-fat eaters. (6) (They lost between 9 and 22 lbs total and kept it off for a year.) But that same study found similar weight loss in other diets, like low-carb diets and the American Diabetes Association diet. The results suggest, the researchers say, that “there is no ideal diet for achieving sustained weight loss in overweight or obese individuals.”
Cons: Teaching your body to burn fat instead of carbs takes time, so you have to be patient while you feel sluggish during the weeks it takes to become fat-adapted. And not every body burns fat as efficiently as carbs, so your endurance may never measure up (though, as we said before, others actually see an improvement here.) Without carbs, your body’s ability to generate explosive energy will most likely decline, so if you love sprinting or HIIT, you might need to consume more carbs than other low-fat dieters. And while you’ll probably lose body fat, this kind of diet is actually keeping you focused on the wrong macro: Studies have proven that the higher protein aspect of a low-carb diet helps promote weight loss, rather than the lower carb count.
“This is a great way of eating that I highly recommend to many clients, and I even model in my own life,” says Elizabeth Shaw, RDN, who is in private practice in San Diego and is the co-author of Fertility Foods Cookbook. “Since the premise of the diet is designed to help people who have high blood pressure, low-sodium foods are recommended. But considering that most Americans exceed their daily sodium levels anyway, it’s not surprising that dietitians recommend this style of eating for treating many different conditions, such as heart disease and obesity.”
On day 2, cook a cup of oatmeal with an ounce of chopped walnuts and 1/2 cup of sliced apples for a breakfast high in fiber and protein; sprinkle in a teaspoon of cinnamon and maple syrup. Have this breakfast again on day 5, but vary the add-ins -- try 1/2 cup of strawberries with thinly sliced almonds. If you like milk with your oatmeal, opt for unsweetened almond or soy.
If you’re science oriented, you can also try his 2008 book “Good Calories, Bad Calories”. For a more journalistic view on the events that led to fat phobia starting in the 1950’s (as well as the joke that is the Mediterranean Diet), there is also Nina Teicholz’s 2014 book “The Big Fat Surprise.” Be sure to check out youtube for some of these folks’ lectures and discussions. They are not advocating whacky stuff.
Many CDEs actually have diabetes…it’s what draws them to choose this career…to help others with diabetes, to share their knowledge. Most already wear an insulin pump and continuous glucose sensors (CGMs) also. When I first became certified on each new pump and CGM, I would wear them (and check my BG 4-6 times per day) for 2-3 weeks, not only to learn the technology really well, but to gain a sense of how my patients must feel having to wear them 24 hours per day. Since, I’ve started a 6 month old baby on a insulin pump and CGM all the way up to a 89 year old…there are no boundaries for people with diabetes!
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.
What the diet advocate says: Controversial Canadian psychologist Jordan Peterson is a fan, crediting the diet for curing his daughter’s various ailments, from juvenile arthritis to depression. But it was popularised by Shawn Baker, author of the aptly titled ‘The Carnivore Diet’ – in which he describes the diet as ‘a revolutionary, paradigm-breaking nutritional strategy that takes contemporary dietary theory and dumps it on its head’.
If the liver is resistant to insulin, that's a bad sign for the rest of the body and could mean there's an increased risk of developing type 2 diabetes, the researchers said. What's more, these results are concerning because overweight patients seeking to reduce their risk of type 2 diabetes by following a ketogenic diet could unintentionally be increasing their risk for developing the disease, at least in the first few days of their diet.
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
For even more impressive effects on body composition: aim for exercise forms which elicit a positive hormonal response. This means lifting really heavy things (strength training), or interval training. Such exercise increases levels of the sex hormone testosterone (primarily in men) as well as growth hormone. Not only do greater levels of these hormones increase your muscle mass, but they also decrease your visceral fat (belly fat) in the long term.
Also, as I believe is mentioned, this diet has been around for along time and was the only way to treat diabetes. And some people did die. However, people still end up dead from t2d even after all the diet advice from educators and with all that pharmacy has to offer. An industry which gains nothing if people just choose to eat less. But has lots to gain if we just keep taking the tablets.
The Keto diet emphasizes weight loss through fat-burning. The goal is to quickly lose weight and ultimately feel fuller with fewer cravings, while boosting your mood, mental focus and energy. According to Keto proponents, by slashing the carbs you consume and instead filling up on fats, you safely enter a state of ketosis. That’s when the body breaks down both dietary and stored body fat into substances called ketones. Your fat-burning system now relies mainly on fat – instead of sugar – for energy. While similar in some ways to familiar low-carb diets, the Keto diet’s extreme carb restrictions – about 20 net carbs a day or less, depending on the version – and the deliberate shift into ketosis are what set this increasingly popular diet apart.