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]
Flexibility. A flexible plan doesn't forbid certain foods or food groups, but instead includes a variety of foods from all the major food groups. A healthy diet includes vegetables and fruits, whole grains, low-fat dairy products, lean protein sources, and nuts and seeds. A flexible plan allows an occasional, reasonable indulgence if you like. It should feature foods you can find in your local grocery store and that you enjoy eating. However, the plan should limit alcohol, sugary drinks and high-sugar sweets because the calories in them don't provide enough nutrients.
Selecting the right food will be easier as you become accustomed to the Keto approach. Instead of lean meats, you’ll focus on skin-on poultry, fattier parts like chicken thighs, rib-eye steaks, grass-fed ground beef, fattier fish like salmon, beef brisket or pork shoulder, and bacon. Leafy greens such as spinach, kale and lettuce, along with broccoli, cauliflower and cucumbers, make healthy vegetable choices (but you’ll avoid starchy root foods like carrots, potatoes, turnips and parsnips). You can work in less-familiar veggies such as kohlrabi or daikon.
There is a lack of scientific research when it comes to the long-term effects of the keto diet. When it comes to healthy eating and weight loss, creating sustainable, lifelong changes will result in the best outcomes. Most importantly, think about how this restrictive eating plan will fit into your lifestyle, and if you are willing to give up what may be some of your favorite foods. It’s important to make time for yourself to prepare meals at home and get regular exercise. Strive for progress, not perfection.

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]


Articles and information on this website may only be copied, reprinted, or redistributed with written permission (but please ask, we like to give written permission!) The purpose of this Blog is to encourage the free exchange of ideas. The entire contents of this website is based upon the opinions of Dave Asprey, unless otherwise noted. Individual articles are based upon the opinions of the respective authors, who may retain copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the personal research and experience of Dave Asprey and the community. We will attempt to keep all objectionable messages off this site; however, it is impossible to review all messages immediately. All messages expressed on The Bulletproof Forum or the Blog, including comments posted to Blog entries, represent the views of the author exclusively and we are not responsible for the content of any message.
Yes, peanut butter is high in calories, but if you stick the real stuff—a tasty combo of peanuts and maybe a touch of salt—the legumes can work their weight loss magic. In addition to providing you with belly-slimming monounsaturated fats, tummy-filling fiber, and metabolism-boosting protein, peanuts also contain genistein, a compound that helps turn down the genes for obesity and reduces your body’s ability to store fat.

“For any individual considering a ketogenic diet, there are laboratory values that a knowledgeable physician should check prior to starting and throughout the course of the diet,” she says. “The best approach is to work with a registered dietitian that is knowledgeable in ketogenic diet therapies and can educate you on ways to make healthier choices on this plan than what dieters would randomly select on their own, along with appropriate supplements that are absolutely necessary on this type of diet.”
“Instead of using a heavy salad dressing, try a drizzle of thick balsamic glaze along with a squeeze of fresh lemon or lime juice” Taub-Dix says. “By cutting the fat in your diet, you can not only save calories, but you can also leave room for healthier fats like avocado or nuts, which are toppings you can actually chew and enjoy with greater satisfaction.”

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.

Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often there is no initial fast (fasting increases the risk of acidosis and hypoglycaemia and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size but alter the ketogenic ratio from 2:1 to 4:1.[9]
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.
Wondering what fits into a keto diet — and what doesn’t? “It’s so important to know what foods you’ll be eating before you start, and how to incorporate more fats into your diet,” says Kristen Mancinelli, RD, author of The Ketogenic Diet: A Scientifically Proven Approach to Fast, Healthy Weight Loss, who is based in New York City. We asked her for some guidelines.
What the diet advocate says: 'The key components of a Mediterranean diet are lots of vegetables, olive oil, oily fish and nuts, with no calorie restrictions. Combine that with cutting down on sugar, which was traditionally a rarity in the region, and you’ve got the base of the Mediterranean diet right. And if you get the base right you can eat a little of whatever else you like,' says Consultant Cardiologist Dr Aseem Malhotra.

The herbs and spices associated with the Mediterranean diet shine at dinner. Meal options include fish like grilled salmon or pan-seared trout, seasoned with lemon and dill; chicken baked with a little olive oil and rosemary; grilled lamb chops with mint; mussels cooked in a tomato, garlic and wine broth; chili made with ground turkey, kidney beans and cayenne, or vegetarian-style with a mix of beans; and scallops sauteed with mushrooms and leeks. Have a 4-ounce serving of protein, and fill the rest of your plate with cooked veggies, like cauliflower, broccoli, brussels sprouts, or green beans.
Chronic stress may increase levels of stress hormones such as cortisol in your body. This can cause increased hunger and result in weight gain. If you’re looking to lose weight, you should review possible ways to decrease or better handle excessive stress in your life. Although this often demands substantial changes, even altering small things – such as posture – may immediately affect your stress hormone levels, and perhaps your weight.
There’s been no poultry or red meat so far in the menu, so plan for two dinners a week incorporating these animal foods instead of fish. Eat with family or friends, whenever possible, and listen to music instead of watching TV. Enjoy a glass of red wine with your meal; a moderate intake gives you polyphenols -- natural compounds in grapes -- that may protect you from heart disease, cognitive problems and even cancer.
Milk is limited. There are no long-term risks to eating Mediterranean, says Cohen. But you may be put off if you’re big on eating a lot of milk and rely on it to get all the calcium you need. You’ll get to eat cheese and yogurt, but in smaller amounts. "To get enough calcium in the diet without milk, one would need to eat enough yogurt and cheese, or seek nondairy calcium sources," says Cohen. If needed, drink skim milk. Otherwise, nondairy calcium sources include fortified almond milk, sardines, kale, and tofu made with calcium sulfate. (30)
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.
Another weight-loss-friendly substitute to keep in mind is favoring salsa over ketchup. While ketchup typically has around 19 calories and 4 grams of sugar per tablespoon, fresh tomato salsa has about 5 calories per tablespoon, no added sugar, and is packed with nutritious veggies. Tomatoes, for example, are loaded with fat-blasting fiber and vitamin C, a deficiency of which has been associated with increased body fat and larger waists. If you can handle spice, toss some jalapenos in your salsa to rev up your metabolism. For more on how you can switch your metabolism into overdrive, check out The 55 Best Ways to Boost Your Metabolism!
First, a little background: Eric Westman, MD, director of the Duke Lifestyle Medical Clinic, explained to Health in a previous interview that in order to successfully follow the keto diet, you need to eat moderate amounts of protein, reduce your carb intake, and increase fats. When you reduce your carb consumption, your body turns to stored fat as its new fuel source—a process called ketosis. To stay in ketosis, followers of the keto diet must limit their carbs to 50 grams a day, Dr. Westman says.
We do recommend everyone eat something every 4-5 hours to maintain a healthy metabolism. If your meals are more than 4-5 hours apart, a snack consisting of a protein and a carbohydrate is a great choice. The protein will help fill you up quicker and keep you feeling satisfied between meals. The protein also has a slower effect on your blood glucose than most carbohydrates, so when paired with carbohydrates, your blood sugar will not spike nearly as high. We recommend eating a protein with every meal and snack.
In a bowl, combine 1 1/2 cups low-fat yogurt (any flavor), 1 large egg, 1 cup whole-wheat or buckwheat pancake mix and 3/4 cup fat-free milk. This recipe makes five servings (each serving is four small pancakes). Have one serving now, and pack away four individual servings in the freezer for upcoming meals. Serve with 2 tablespoons light maple syrup, 1 cup fat-free milk and 1 cup fresh strawberries.
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.

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!

Researchers at Florida State University studied watermelon for its ability to regulate blood pressure due to it being “one of the richest natural sources of L-citrulline”, an amino acid that the body converts into L-arginine, which improves circulation. They discovered that watermelon, due to its high L-citrulline, may prevent pre-hypertension from becoming full blown hypertension.
These carbohydrate recommendations are not PER DAY, they are per meal. This is the major difference between Ketogenic diets and a consistent, low carbohydrate diet CDEs advocate for. 30-45 carbs per meal is considered a low carb diet. Eating this in the form of a Mediterranean diet is what I recommend and what my article outlined. In a perfect world, we try to have people steer clear of anything artificial or processed when possible. Just eat fresh foods, like our grandparents did, who never had these types of health problems.
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.’

Hi Barb, That can definitely be it. Losing when you are close to goal can be more difficult. It could also be that your body’s healthy weight is a little higher than what you’d like – which doesn’t mean you can’t lose, but makes it more difficult. If just eating Keto foods isn’t working, double check the macros for your weight and see if the amount you’re eating needs to be adjusted. You’ll find more help and support in our support group here.

Another weight-loss-friendly substitute to keep in mind is favoring salsa over ketchup. While ketchup typically has around 19 calories and 4 grams of sugar per tablespoon, fresh tomato salsa has about 5 calories per tablespoon, no added sugar, and is packed with nutritious veggies. Tomatoes, for example, are loaded with fat-blasting fiber and vitamin C, a deficiency of which has been associated with increased body fat and larger waists. If you can handle spice, toss some jalapenos in your salsa to rev up your metabolism. For more on how you can switch your metabolism into overdrive, check out The 55 Best Ways to Boost Your Metabolism!
The food options available on the DASH diet closely mirror the eating plan recommended in the US Department of Agriculture’s MyPlate, with a focus on whole foods, such as fruit and veggies; fat-free or low-fat dairy; whole grains; and lean meats, like fish and poultry. (3) Meanwhile, the plan requires cutting back on, or preferably eliminating, processed foods, like sugary drinks and packaged snacks, and limiting red meat, which in excess has been linked to poorer heart health and heart failure, according to a study published in the journal Nutrition, Metabolism and Cardiovascular Diseases. (4)

This drug is an injected variant of a satiety hormone called GLP-1. It slows down how quickly the stomach empties and tells the brain that you don’t need to eat yet – a great idea for losing weight. As a bonus this drug works fine while one is on the keto diet and it works even better with intermittent fasting – for a rapid weight loss with no hunger.
Sesame seeds likely aren’t one of those foods you pay any mind to, but the crunchy little buggers have been shown to play a crucial role in weight maintenance and deserve to be tossed into a salad or whole wheat noodle dish. Researchers suspect its the lignans—plant compounds—found in sesame seeds (and flax seeds) that makes them so special. In a 2015 study, women who consumed high levels of lignans tended to weigh less and gain less weight over time when compared to women who didn’t consume these compounds in high amounts.
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.
Thanks for posting this Edward. While I agree that the thought of a lifetime without any sweets or any grains sounds miserable, it’s even more miserable every time I see a number above 120 on my meter, which is guaranteed to happen every time I eat even a few bites of one of those foods. Yeah, it’s stressful (and cortisol is just as much of a pain as T2D), but I want a better life and a life off of drugs. I was on three orals and two shots of insulin daily.
This is a great site for information, details, recipes, etc… one of the reasons I started looking into this way of eating is my husband suffers from high blood pressure, cholesterol and type 2 diabetes. We are not exceptionally overweight, however could both use to lose 10-15 lbs/ea. I also have facial and ocular rosacea and have heard good things about this way of eating for an overall improvement in numerous areas. Although I may have missed it I haven’t seen anywhere you might have mentioned your weightloss success. Thank you for sharing your wealth of information.

I am one of those strange people that enjoys reading about nutrition. I chose this book merely for this "diet" being listed as number one for the past few years. While I completely agree with the majority of the principals there are a few things I found disturbing. No coconut oil? However, margarine, Sugar free jello, low fat dairy products, diet drinks, and artificial sweeteners are promoted in this plan. Seriously? I am by no means a Purist but to put sugar free jello on a daily meal plan?
There is a lack of scientific research when it comes to the long-term effects of the keto diet. When it comes to healthy eating and weight loss, creating sustainable, lifelong changes will result in the best outcomes. Most importantly, think about how this restrictive eating plan will fit into your lifestyle, and if you are willing to give up what may be some of your favorite foods. It’s important to make time for yourself to prepare meals at home and get regular exercise. Strive for progress, not perfection.

Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those that have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram (EEG) shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and it has been suggested that children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[45]


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.
Hi Barb, That can definitely be it. Losing when you are close to goal can be more difficult. It could also be that your body’s healthy weight is a little higher than what you’d like – which doesn’t mean you can’t lose, but makes it more difficult. If just eating Keto foods isn’t working, double check the macros for your weight and see if the amount you’re eating needs to be adjusted. You’ll find more help and support in our support group here.
Changing your body’s primary energy source from carbohydrates to fat causes an increase in ketones in the blood. This “dietary ketosis” is different from ketoacidosis, which is an extremely dangerous condition. When you have too many ketones, you may be at risk for developing diabetic ketoacidosis (DKA). DKA is most prevalent in type 1 diabetes when blood glucose is too high and can arise from a lack of insulin. Although rare, DKA is a possibility in type 2 diabetes if ketones are too high. Being ill while on a low-carb diet may also increase your risk for DKA.
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]
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.
Articles and information on this website may only be copied, reprinted, or redistributed with written permission (but please ask, we like to give written permission!) The purpose of this Blog is to encourage the free exchange of ideas. The entire contents of this website is based upon the opinions of Dave Asprey, unless otherwise noted. Individual articles are based upon the opinions of the respective authors, who may retain copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the personal research and experience of Dave Asprey and the community. We will attempt to keep all objectionable messages off this site; however, it is impossible to review all messages immediately. All messages expressed on The Bulletproof Forum or the Blog, including comments posted to Blog entries, represent the views of the author exclusively and we are not responsible for the content of any message.
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