Type 2 diabetes is one of the most pressing challenges of our time and its ultimate cause has not been fully understood. Ketogenic diets, which are low in carbohydrate and high in fat, are known to lead to weight loss and have been considered to be healthy. These findings raise new questions about ketogenic diets and whether or not they are actually healthy.
When you're deciding to go on a diet, there are so many options to choose from. You can go keto and focus on healthy fats, try intermittent fasting, or just eat a certain amount of calories a day. One option you might not have tried yet, though, is the DASH diet, which has a simple goal: keeping your body (especially your heart!) as healthy as possible.
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.
Though we singled out quinoa above, whole grains in general (we’re talking cereal, rice, pasta, and more) are conducive to weight loss, especially when they’re used in place of refined—white—grains. In fact, a study published in the American Journal of Clinical Nutrition found that substituting whole grains for refined grains in the diet increases calorie loss by reducing calories retained during digestion and speeding up metabolism. Unlike refined grains, whole grains are packed with satiating, heart-healthy fiber.
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.
In a second study,2 a Harvard-led research team evaluated the benefit of a ketogenic diet in both children and adults with type 1 diabetes despite concerns about a possible negative effect on growth and development in children following such a restricted diet. These researchers report "exceptional" glucose control with little adverse effects. However, the participants were recruited from a closed Facebook group, TypeOneGrit, for people who follow a diet and diabetes program based on the recommendations in the Diabetes Solution,3 a book by Richard K Bernstein, MD, who devised this program to manage his own type 1 diabetes.
“When we measured fasting plasma levels, we found low insulin and low glucose, which is good — not suggestive of diabetes,” he says. “However, when we challenged the animals with glucose — giving them a relatively large amount of glucose, as they would get by ingesting a meal — we found that their plasma glucose levels went higher than mice on normal chow and stayed high longer.”
The types of foods listed are not comprehensive. For example, avocados are not included so it is not clear if they would be categorized as a fruit or a fat serving. Certain foods are placed into questionable categories: pretzels are placed in the grain group even though they have fairly low nutrient content and no fiber; frozen yogurt is placed in the dairy group even though most brands contain little calcium and vitamin D and are high in added sugar. The general term “cereals” are placed in the grain group but different types of cereals can be highly variable in nutrient and sugar content.
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:
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.
The results showed a 49%-62% decrease in diabetes risk in individuals who adhered to the diet on a medium to high basis, meaning they stuck to it as closely as possible. What’s even more interesting is that the research noted that the participants who benefited the most from the reduction were men with a waist circumference of 94 or more, and women with a waist circumference of 80 or more.
The subjects had a mean BMI of 42.2, mean age of 56 years, and were of either African-American or Caucasian descent. In their intervention, subjects consumed a LCKD diet with the goal of eating less than 20 grams of carbohydrates per day while reducing dosages of diabetes medication. Subjects also received nutritional counseling and medication adjustment every two weeks.
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.
I know it is hard when you have been taught something, and believed it, and taught it to others…only to be shown that what you have been taught is not the end all be all that you were led to believe. It sucks. But, you can choose to ignore the truth, and continue to follow the incorrect path. Or, you can look at the facts, and realize that what you have been taught is not the truth…and you can take a new path, which will lead many to wonderful new lives.
Due to the highly restrictive nature of the keto diet, it is not safe for certain populations, including pregnant or postpartum women, children or growing teenagers, or individuals with certain diseases. If you are considering this diet, it is important that you speak with your primary care physician first and work with a Registered Dietitian Nutritionist to make sure you are getting all of the essential nutrients your body needs to thrive.
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.
The trick here is not only to avoid all obvious sources of carbohydrate (sweets, bread, spaghetti, rice, potatoes), but also to be careful with your protein intake. If you eat large amounts of meat, eggs and the like, the excess protein will be converted into glucose in your body. Large amounts of protein can also raise your insulin levels somewhat. This compromises optimal ketosis.
“Tremendous Results”….guess that’s why the diabetes nationwide gets worse every year, because of the stellar advice your kind is giving out. I’ve been on the virta clinic for two months and already went off insulin, Janumet and Jardiance, which I’ve been on for 10 years, with blood sugars between 80 and 150. The advice you give makes people get sick slower. The ketogenic approach deals with the real issue, carbohydrate intolerance. If you are lactose intolerant you stop ingesting lactose. Type two diabetes is simply carbohydrate intolerance. Stop eating the carbs and the symptoms go away. I think you meet to cite some of the other research out there I’ve read in other books and the work the Virta Clinic has done. In my opinion you’ve cherry picked data to suit your preconceived beliefs.
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.
The DASH Diet, which stands for dietary approaches to stop hypertension, is promoted by the National Heart, Lung, and Blood Institute to do exactly that: stop (or prevent) hypertension, aka high blood pressure. It emphasizes the foods you've always been told to eat (fruits, veggies, whole grains, lean protein and low-fat dairy), which are high in blood pressure-deflating nutrients like potassium, calcium, protein and fiber. DASH also discourages foods that are high in saturated fat, such as fatty meats, full-fat dairy foods and tropical oils, as well as sugar-sweetened beverages and sweets. Following DASH also means capping sodium at 2,300 milligrams a day, which followers will eventually lower to about 1,500 milligrams. DASH Diet is balanced and can be followed long term, which is a key reason nutrition experts rank it as U.S. News’ Best Overall Diet, tied with the Mediterranean Diet.
A systematic review in 2018 looked at sixteen studies on the ketogenic diet in adults. It concluded that the treatment was becoming more popular for that group of patients, that the efficacy in adults was similar to children, the side effects relatively mild. However, many patients gave up with the diet, for various reasons, and the quality of evidence inferior to studies on children. Health issues include high levels of low-density lipoprotein (LDL), high total cholesterol, and weight loss.
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.
Dr. Brian Mowll is the founder and medical director of SweetLife® Diabetes Health Centers and serves clients worldwide as The Diabetes Coach™. He is a master licensed diabetes educator (MLDE), CDE, and was one of the first doctors to be certified to practice functional medicine by the prestigious Institute for Functional Medicine. Since 1998, Dr. Mowll has been helping people across North America to optimize their health and metabolism, control blood sugar, and reverse type 2 diabetes using a natural, personalized lifestyle approach.
There’s also some evidence that it might help with type 2 diabetes. “An emerging body of research is finding that a keto plan may have some real benefits thanks to its ability to improve the body’s ability to use insulin and also help control appetite, which can result in easier weight loss,” says Karen Ansel, R.D.N., co-author of Healthy in a Hurry.
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.
^ Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–63. doi:10.1542/peds.102.6.1358. PMID 9832569. https://web.archive.org/web/20040629224858/http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM Lay summary]—JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.
“So many of us sacrifice this for work, family, or social experiences, but sleep is a basic tenet of health; you will not function properly, cognitively or physically, without adequate sleep,” Moreno explains. "Adequate usually means at least 8 hours. Set strict sleep time rules and practice good sleep hygiene. When you prioritize sleep, other aspects of good health may line up more easily.”
Hello, I am hoping someone can reach out to me and explain something. My son who is T1D just started the keto diet 4 days ago. At first we were doing great numbers were good, then out of nowhere we are having highs! He is correcting and it’s not bringing him down into normal range. I am going into a panic, I don’t know what to do, or who to ask for help. His doctor would be no help, and thinks the Standard American Diet is fine. I don’t see eye to eye with him. I hope someone can tell me why this might be happening. Thanks in advance for your time!
Blueberries are lousy with antioxidants, satiating fiber, potassium, and more, and according to researchers at the University of Michigan, the colorful fruits may also encourage weight loss. In a study of laboratory rats, scientists found that after 90 days the rats who received blueberry-enriched powder as 2 percent of their diet had less abdominal fat, lower triglycerides, lower cholesterol, and improved fasting glucose and insulin sensitivity, than the rats who weren’t given any blueberry-enriched powder.
Full disclosure: I have followed a low-carb diet for nearly a decade and find no problem adhering to it. I’ve lost weight and all my cardiovascular biomarkers have improved. Moreover, I’ve studied the science and history behind low-carbohydrate diets, so beyond my personal experience, I bring an evidence-based perspective. (Previously, for 25+ years, I adhered faithfully to a “mostly plants” regimen of fruits, veggies, and whole grains, including my own homemade 7-grain bread, while exercising religiously. Yet during that time my blood lipids were unhealthy, and I never could shake an extra 10-20 pounds.)
My principal hope in this article is to provide journalists with a resource to do what basic journalism demands, namely to ensure that stories are scientifically balanced and accurate. At the end of this post I provide contacts for some of the credentialed experts who helped me compile this research. Reporters, please seek out these or other low-carb diet experts so you can provide accurate, up-to-date information for your readers.
Also worth noting is that low-carbohydrate, low-GI, and Mediterranean diets led to significant improvements in blood lipids with up to a 4–10% increase in HDL (4% in the Mediterranean, 5% in low-GI, and 10% in low-carbohydrate diets), 1–4% reduction in LDL (1% in low-carbohydrate, 3% in low-GI, and 4% in Mediterranean diets), and 9% reduction in triglycerides. 
“Acknowledge that health is an onion; it's layered and complex, and isn't just about nutrition,” Moreno says. “Map out your health and wellness path by creating lists of issues vs. goals in your life within the realms of nutrition, movement, sleep, stress, spiritual, social, and medical issues. You’ll learn to see yourself as an amalgam of health traits and not just a roster of foods you ate in the last week.”
We recently published an article documenting the grim long-term effects of low-carbohydrate diets, in which we explain the evidence-based research showing that low-carbohydrate diets high in fat and protein including meat, dairy products, eggs, fish, and oil actually worsen diabetes health, increase cancer risk, increase cholesterol, increase atherosclerosis, harden blood vessels, and increase all-cause mortality.
Because some cancer cells are inefficient in processing ketone bodies for energy, the ketogenic diet has also been suggested as a treatment for cancer. A 2018 review looked at the evidence from preclinical and clinical studies of ketogenic diets in cancer therapy. The clinical studies in humans are typically very small, with some providing weak evidence for anti-tumour effect, particularly for glioblastoma, but in other cancers and studies, no anti-tumour effect was seen. Taken together, results from preclinical studies, albeit sometimes contradictory, tend to support an anti-tumor effect rather than a pro-tumor effect of the KD for most solid cancers.
Stock up: Jet.com's new City Grocery service (available in select markets) makes it easy to ensure you always have keto-friendly veggies in the fridge. We love their delivery scheduling tool; simply fill your cart, then decide which day and timeframe you'd like your groceries delivered. One of our faves: Urban Roots Green Squash Veggie Noodles are great for whipping up low-carb "pasta" dishes.