The ADA has recommended since 2013 we use our best clinical judgement in recommending a low carbohydrate diet for people with diabetes, recognizing it needs to be individualized. 60-75 grams is the carbohydrate amount I would give to a very tall, large boned man or perhaps an active teen or young adult. I would never recommend that many carbohydrates for an average size man who was trying to lose weight; he would get 45-60 grams of carbohydrates per meal and 15-30 grams for snacks. A women trying to lose weight would get 30-45 grams of carbohydrates per meal and 15 grams for snacks.
In the study, the researchers fed mice a ketogenic diet for several days and expected to find a favorable outcome — perhaps weight loss or another indication of improved health. Instead, they found that the liver began resisting insulin almost immediately and the mice were unable to regulate their blood sugar levels after only three days on the diet. (Insulin resistance, meaning that cells in the body don't respond to insulin, is a key characteristic of type 2 diabetes.)
My husband and I have been doing this diet for a while now. And let me tell you it works. He has lost weight and his blood pressure has gone down!! It isn't a hard diet at all, the first 2 weeks you learn to live without carbs , but that isn't to bad. The 2nd phase you start adding some carbs back along with other foods. It's all about making the right choices.
I suffered through a year on 20 grams of carbs per day and it was the worst year of my life. Yep, I lost weight, but at my current weight of 130 lbs and eating 30 carbs per meal and remaining in a prediabetes state for 15 years, I am healthy AND happy now. None of us know the long term effects of most of what is offered to us…medications, diet drinks, processed foods, restrictive diets. The point I was trying to make was eating healthier, more natural foods will be better in the long run, I believe we all have the common sense to agree on that, even if we can’t agree on how many carbs we will eat!
The basal metabolic rate per gram of body weight is seven times greater in mice than in humans. Organisms with large mass-specific metabolic rates typically show relatively large deviations from "normal" values because of a weak capacity to maintain homeostasis. Mice, which have a higher mass-specific metabolic rate, have a weak capacity to maintain cellular homeostasis; humans have a lower mass-specific metabolic rate, and a strong capacity to maintain cellular homeostasis. Mice are not small people, and "everyone else did it" is not a sound experimental design rationale.
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.
As Tammy points out, diets are diets, and many people nowadays think/feel that diets are a “time/value-based goal”. “If I just get my weight down, or if I just fix this, then I’ll be all set…” WRONG!!! There in lies the first problem. How long can it be maintained? Well that’s a good point. The real question is, how long is one committed to changing their life, and how strong is their desire to do it. ALL things that one wants to change in life, require a change in to the way their living and/or perceiving life. They require a life-style change. One could attempt a Mediterranean diet, and yet relapse back to “normal” eating after 3mos, 1yr, 3yrs, etc.. It doesn’t really matter if the change isn’t first on the mental and emotional level. Unfortunately, many first-world daily diets (namely American) incorporate many foods that are addictive which can cause cravings. And yes, the cravings are scientifically prove-able, and have been proved. We grow up thinking that it’s “normal” to have your cake (since its the carb of debate lol) and eat it too, because why?… Well because that’s how they were raised. Simply as that. Conditioned living if you will. There are many cultures on this planet that DO NOT grow up eating as many carbs and sweets as the American Diet, and do perfectly fine without all the sugars and carb cravings. And incidentally, they also lead healthier lives too… Go figure.
“Having your groceries delivered cuts back on the impulse buys, wasting money, and over portioning. Plus, you can pre-load your weekly list so it's effortless,” Moreno explains. Moreno also recommends keeping healthy snacks on your “auto-ship” list on Amazon. This way, you never run out! Moreno swears by these delectable protein brownies. “Stash one in every purse!”

As far as the Ketogenic Diet is concerned, I think I am going to have to make a full about-face. As you said, for some people like yourself, you were unable to eat in moderation and feel it is due to your genetic makeup. This is probably true…to add insult to injury, in addition to genetics, it could also be an inflammatory process going on due to the sugary drinks and processed foods we are eating causing obesity and a host of other issues.
Eating low-carb paleo means removing items like rice, pasta, and legumes from your diet completely, but the carbs you eat will be from vegetables like fruit, beets, sweet potatoes, and leafy greens, such as spinach and kale. The diet also cuts out processed food plus foods allowed on other low-carb diets, including milk and cheese, and some people have an easier time sticking with the diet when more carbs are included.

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.

That doesn’t mean keto causes diabetes; it’s amazing for most diabetics. However, if your cells are great at processing fat, but suck at processing glucose or carbohydrates, you won’t be able to run at full power, and parts of your body that prefer glucose over fat — like the glial cells in your brain that handle immune function and synaptic pruning — don’t work as well over time.

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.


Although white potatoes offer some potassium and fiber, sweet potatoes reign supreme in the nutrition department, meaning you should consider adding sweet potatoes to your diet. A large sweet potato contains around 4 grams of satiety-boosting protein, 25 percent of the day’s belly-filling fiber, and 11 times the recommended daily intake of vitamin A. What’s more? It’s less than 200 calories.
This diet plan will be especially important for people with metabolic syndrome, prediabetes, or diabetes. Post menopausal women will find that this plans helps them lose that extra midlife weight that is so troublesome. It will reduce your body's demand for insulin, and reduce the tendency to deposit fat in your midsection. Yes, that's right - this plan will reduce your waist size, which is an important indicator of health risks.

Bonnie J. Brehm, Randy J. Seeley, Stephen R. Daniels, and David A. D’Alessio, “A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women,” The Journal of Clinical Endocrinology & Metabolism: Vol 88, No 4; January 14, 2009. http://press.endocrine.org/doi/full/10.1210/jc.2002-021480.
Great article! Sustainability is key and Keto diet is extremely restrictive compared to others. Many of the comments I see don’t understand the importance of many years of research before stating something has a “significant difference” than the recommendations that are already in place. Also, understanding the pro/carb/fat balance in each meal instead of focusing on just carbohydrates. We have practiced the same modified Mediterranean diet at my practice where someone can enjoy life, eat complex carbohydrates and years later they are still successful and hundreds of pounds have been lost for good 🙂 Thank you for the reminder (and the comparison of Adkins supported research).
Well, I am going to give this another try. I have great difficulty in eating greens , or drinking them, also I am not fond of fats, years and years of low fat diets have totally screwed my metabolism,and taste buds. I will read this page every day to keep my mind focused. Start tomorrow when I get up …… I work nights which can cause me problems as well. When I tried this diet before, I got terrible cramp, now I realise I wasn’t drinking enough water. Anyway.here goes.

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]
What to know about diet soda and diabetes Sugary drinks are a known cause of obesity and blood glucose problems, such as diabetes. Diet options are available, but are they good for people with diabetes? Artifical sweeteners may be linked to diabetes development. This MNT Knowledge Center article gives information on diet soda, sweeteners, and alternatives. Read now

What to know about diet soda and diabetes Sugary drinks are a known cause of obesity and blood glucose problems, such as diabetes. Diet options are available, but are they good for people with diabetes? Artifical sweeteners may be linked to diabetes development. This MNT Knowledge Center article gives information on diet soda, sweeteners, and alternatives. Read now

The fact is, the stress that you will bring on yourself from constantly restricting every single thing you put in your mouth is far more detrimental to your health. Remember, moderation is the key! You can count your carbohydrates and follow a sensible low carbohydrate diet to control your blood glucose and your weight. Exercise will always be the key component to add that contributes to added weight loss.
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:

I’ve been type 2 for about 15 years was pretty stable with diet and Metformin for 10 years. But eventually started trying more aggressive treatment like Victoza and without fail in 4 years I was on slow acting insulin. I lost weight lowered carb intake to 40mg or less in the morning my breakfast has been no carbs. People need to realize every diabetic is different you must manage it how it keeps you with good A1C levels. I myself got off insulin for a year and half but my fasting levels slowly increased again. Reversing diabetes is not possible. Reducing the effects is possible and more likely the better you monitor yourself and do what you need to do. Depending on medications or diets or counting carbs will all help but not cure the diabetes. These all are things that reduce its ability to affect your health negatively.

On day 1, lunch is 3 cups of spinach topped with 3 ounces of salmon or sardines; the greens are loaded with vitamins A and K, plus iron, while the fish supplies protein and omega-3 fats. Include some chopped veggies on your salad, like tomato, broccoli and bell pepper for fiber and vitamin C to help you absorb the iron. Have a salad again on day 5, but use romaine lettuce this time, and substitute cannellini beans for your protein and choose cucumber, carrots and asparagus tips as veggies. Opt for olive oil and red wine or balsamic vinegar for your dressing.
Based on long-overlooked DASH research and developed into a weight loss plan by the foremost DASH dietitian and leading nutrition expert, Marla Heller, MS, RD, this effective and easy weight loss program includes menu plans, recipes, shopping lists, and more. Readers will enjoy a diet rich in fruits, vegetables, low-fat and nonfat dairy, lean meats/fish/poultry, nuts/beans/seeds, heart healthy fats, and limited amounts of whole grains. The result: improved metabolism, lower body fat, improved strength and cardiovascular fitness, without counting calories. And, of course the DASH diet can lower cholesterol and blood pressure without medication!

I must tell you when looking at this link they say the American Diabetes Association Guidelines call for 60-75 carbohydrates per meal and that is simply not true. The ADA has recommended since 2013 we use our best clinical judgement in recommending a low carbohydrate diet for people with diabetes, recognizing it needs to be individualized. 60-75 grams is the carbohydrate amount I would give to a very tall, large boned man or perhaps an active teen or young adult. I would never recommend that many carbohydrates for an average size man who was trying to lose weight; he would get 45-60 grams of carbohydrates per meal and 15-30 grams for snacks. A women trying to lose weight would get 30-45 grams of carbohydrates per meal and 15 grams for snacks.
There are numerous benefits that come with being on keto: from weight loss and increased energy levels to therapeutic medical applications. Most anyone can safely benefit from eating a low-carb, high-fat diet. Below, you’ll find a short list of the benefits you can receive from a ketogenic diet. For a more comprehensive list, you can also read our in-depth article here >
Christian Wolfrum, one of the corresponding authors on the paper said 'Diabetes is one of the biggest health issues we face. Although ketogenic diets are known to be healthy, our findings indicate that there may be an increased risk of insulin resistance with this type of diet that may lead to Type 2 diabetes. The next step is to try to identify the mechanism for this effect and to address whether this is a physiological adaptation. Our hypothesis is that when fatty acids are metabolized, their products might have important signaling roles to play in the brain.'
Part of slimming down involves a simple, sensible exercise and an easy-to-follow nutrition plan. This full week of meals will take the guesswork out of grocery shopping and prepping with nutritionist-approved breakfast, lunch, and dinner ideas. If you have a higher activity level, check out these 1,300-, 1,400-, 1,500-, and 1,800-calorie meal plans as well.
According to the Mayo Clinic, the DASH diet calls for eating lots of fresh veggies and fruits, but it requires consuming only a moderate amount of whole grains, as well as lean sources of protein and healthy fats, such as fish and nuts, respectively. (6) This distinguishes the DASH Diet from other popular plans, such as the Atkins diet and the ketogenic diet, or the high-fat, low-carb diet.

Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions.[18] Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.[3]
Cyrus Khambatta earned a PhD in Nutritional Biochemistry from UC Berkeley after being diagnosed with type 1 diabetes in his senior year of college at Stanford University in 2002. He is an internationally recognized nutrition and fitness coach for people living with type 1, type 1.5, prediabetes and type 2 diabetes, and has helped hundreds of people around the world achieve exceptional insulin sensitivity by adopting low-fat, plant-based whole foods nutrition.
My husband and I have lost weight after just 2 weeks on this. Not a lot, but enough to lose a belt loop. I've been menopausal for years, along with having an underactive thyroid, and losing weight has been almost impossible for me for the last few years. I'm unable to exercise much due to torn ligaments in my foot. Following this weight loss solution really helped. I'm going to get the other book with more recipes. Cutting out breads and sugar really did make a difference!
Benefits The main ingredient in hummus, chickpeas pack an impressive amount of fiber (more than half of a woman’s 25 g daily quota), as well as iron, zinc, folate, and magnesium, according to a paper published in November 2014 in the journal Applied Physiology, Nutrition, and Metabolism. (15,16) The stats above are for a whole cup, but you only need ½ cup per day to reap the benefits.

“Unlike many popular diets, there’s really not a huge focus on eliminating starches,” Srinath says. “What most studies have found is that dieting is really about sustainability—so the people who lose the most weight are those who are able to maintain a diet and keep up with it," she says. "A big issue with a lot of the low-carb diets out there is that it’s really, really hard to limit carbs completely. That’s why I think DASH is more palatable to people." Yaaas, carbs!


Bonnie J. Brehm, Randy J. Seeley, Stephen R. Daniels, and David A. D’Alessio, “A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women,” The Journal of Clinical Endocrinology & Metabolism: Vol 88, No 4; January 14, 2009. http://press.endocrine.org/doi/full/10.1210/jc.2002-021480.
It’s time to focus on your lentil health. In one four-week Spanish study, researchers found that eating a calorie-restricted diet that includes four weekly servings of legumes aids weight loss more effectively than an equivalent diet that doesn’t include beans. Those who consumed the legume-rich diet also saw improvements in their “bad” LDL cholesterol levels and systolic blood-pressure. To reap the benefits at home, work lentils, chickpeas, peas and beans into your diet throughout the week.
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.
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.

DASH stands for Dietary Approaches to Stop Hypertension. It’s a lifelong approach to eating that’s designed to prevent and treat high blood pressure, also called hypertension. It also falls in line with dietary recommendations to prevent osteoporosis, cancer, heart disease, stroke, and diabetes.  DASH encourages a variety of nutrient-rich foods while reducing the amount of sodium eaten. This eating plan includes plenty of fruits, vegetables, whole grains, low-fat dairy products, fish, poultry, legumes, nuts, and seeds.  Red meat and sweets are eaten in small amounts.
What is your opinion on the conflicting opinions about whether or not wine is healthy or harmful? It seems there is a daily article touting research that proclaims wine is health alternating with another article about research that indicates that even moderate intake of wine is associated with cancer or dementia. I’m trying to understand all of this conflicting data with the reality/evidence of Mediterranean cultures that include daily intake of wine. Is it the amount drunk that is key?
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.
The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[18] On admission, only calorie- and caffeine-free fluids[36] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[18]
The "all meat all the time" low-carb approach or strict veganism can be great options for people who thrive on clear diet rules (and those two are actually the most popular diets out there) but these extremes are not for everyone. If you prefer more of a moderate approach, the Flexitarian diet is the clear winner. The "flexible vegetarian" mindset allows you a healthy balance of plant-based foods, responsibly sourced meats, and quality fats. The best part? It's not super restrictive, so you have plenty of nutritious food options. (Start here: How to Adopt a Flexitarian Diet)
I would love to join a study! Could you recommend where to go to find one? I have done 30 or less total carbs a day for almost 2 years and feel great. I have NEVER EVEN ONCE gone over 40 total so I do follow it and I do not cheat on high carb foods, although I do occasionally over-eat on low carb foods resulting in a bit over 30 maybe 1 -2 times a month. I do feel that time will provide more support and think that the medical community should educate on this as another alternative. It isn’t for everyone because it is a bit more problematic if a person does fall of the straight and narrow too often but it can be done!
You even have root vegetable and a picture of a carrot. Carrots are not part of a keto diet and as far as I have seen never were. They have 2 much sugar content and are discouraged except in very small amounts. Are you sure you tried it? Sorry. Great article in many ways but outdated in others. I don’t think people go into thinking they will “do it forever” How long can I last? I think that is missing the point entirely. So many people are getting their triglycerides down, losing weight reducing stroke possibilities lengthening their very lives. It is just not fair to not at least point out a few of these things as much as the risks you made sure to point out. albeit they are very important. How about the risks of not doing something? How about the list of people that found this and turned their lives around. Also, I know several people who have been doing keto for years.
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.
It’s low in saturated fat. You’re not going to feel hungry eating this way, because you can build in a variety of healthy fats. But by limiting large amounts of red or processed meats and relying heavily on monounsaturated fatty acids, like avocado, nuts, or olive oil, you’ll keep saturated fat levels low. These fats don't lead to high cholesterol the same way saturated fats do. Healthful sources of fat include olive oil, fish oils, and nut-based oils, Cohen explains.
In the study, researchers fed mice (!) a keto diet for three days (!), and then ran a glucose tolerance test. They noticed that while the mice on a keto diet had a lower fasting blood glucose, it got higher after the glucose tolerance test and there were signs of a reduced effect of insulin compared to mice on regular mouse chow. That’s basically it.
Probably, and there are a few reasons why the keto diet usually equals weight-loss gold, says Keatley. For starters, people usually reduce their daily caloric intake to about 1,500 calories a day because healthy fats and lean proteins make you feel fuller sooner—and for a longer period of time. And then there’s the fact that it takes more energy to process and burn fat and protein than carbs, so you're burning slightly more calories than you did before. Over time, this can lead to weight loss.
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