The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. There is some evidence of synergistic benefits when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.[3]
MEME WAS TALKING ABOUT DIETS. I GOT THE BOOK ON THE DASH DIET AND I RLY LIKE IT. IT'S A DIET, YEAH, BUT IT'S ALL FOCUSED ON FEEDING YOURSELF GOOD THINGS, FOCUSING ON HITTING TARGETS FOR GETTING THE NUTRITION YOU NEED (A CERTAIN AMOUNT OF SERVINGS OF VEGGIES, FRUIT, LOW-FAT DAIRY, WHOLE GRAINS, ETC.) INSTEAD OF ON CALORIES. BUT CALORIES ARE STILL PART OF THE EQUATION, SO IT'S ALL SO FUCKING REASONABLE. IL IT.
When foods are processed, their potassium levels actually decrease. So, choosing whole or minimally processed foods can improve blood pressure regulation from both a sodium and a potassium perspective. In addition, you’ll usually decrease your intake of saturated fat, added sugars, and overall calories—all of which can help you lose weight, and keep it off for good. 
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.)
Also, if you listen to Dr Bernstein talk about his childhood (he is well into his 80’s), the “original” recommended diet was only ketogenic in the sense that it was high-carb and caused keto-acidosis, which he describes as almost killing him as a teenager. He still considers the ADA recommendations as ketogenic for this reason (you only have to listen to him a short time to hear him railing against the ADA).

I have multiple autoimmune diseases. I fought 4 doctors, all of whom told me that adults can’t get type 1. I finally went to the Jefferson Diabetes Center. Yup! Type 1 diabetes. I’m slender, do marathons, bp 100/60, triglyceride/HDL ratio 1.08. And I STILL fought 4 doctors because of the ADA misinformation. All it takes is a simple blood test to look at antibodies. That’s all it takes, but the test is almost never run.
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.
To encourage ketone production, the amount of insulin in your bloodstream must be low. The lower your insulin, the higher your ketone production. And when you have a well-controlled, sufficiently large amount of ketones in your blood, it’s basically proof that your insulin is very low – and therefore, that you’re enjoying the maximum effect of your low-carbohydrate diet. That’s what’s called optimal ketosis.
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.
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.
A study published in the journal Nutrition & Metabolism discouraged the Atkins diet for anyone with diabetes because the plan doesn’t limit fat, but noted the approach may be a safe way for people without the disease to lose weight effectively. According to a study published in the Journal of the American Medical Association, Dr. Atkins helped women lose weight better than other low-carb diets, such as the Zone diet, the Ornish diet, and the LEARN diet after 12 months.
As both study groups acknowledge, additional research is needed to tease out any and all of the factors that may be producing the weight loss and decrease in HbA1c, says Dr. Gonzalez-Campoy, for example  there may be other mechanisms of action that are helping these individuals to achieve weight loss, including changes in the gut microbiome, increased insulin sensitivity, enhanced leptin response, and decreased ghrelin levels, each of which contribute to weight loss.
But what I think is funny is that the keto diet has been staring us in the face forever. Look at Inuit tribes that survived off of blubber in a region that grows next to nothing most of the year. Yet their people didn’t die out or show signs of metabolic disorders or heart disease until introduced to the modern western diet that prioritizes carbohydrates over fat. Here is an interesting link, however I find the conclusion disheartening and frankly more than a little suspicious. (Basically the people in charge decided to drop the study and introduced a bunch of “what about…” questions to obfuscate a clear pattern in observation across many indigenous people from across the face of the planet and decided the outcome “wasn’t enough” to introduce into public policy…)
It is completely wrong to discuss “average lifespan”. The average lifespans of pre-industrial peoples is heavily reduced by infant and early childhood mortality, which has nothing to do with lack of fresh fruit. Once you remove this bias in the numbers, pre-industrials can have lifespans almost as long as ours. And usually without many of the degenerative diseases that bother our middle and old ages.
At first glance the ketogenic (keto) diet may seem like a crazy idea for type 2 diabetics. After all, many patients are put on diets to help them lose weight. The keto diet is high in fat, but it is very low in carbs, and this combination can help change the way your body stores and uses energy. With this diet your body converts fat instead of sugar into energy, which can improve blood glucose levels while reducing the need for insulin.
There are so many tricks, shortcuts, and gimmicks out there on achieving optimal ketosis – I’d suggest you don’t bother with any of that. Optimal ketosis can be accomplished through dietary nutrition alone (aka just eating food). You shouldn’t need a magic pill to do it. Just stay strict, remain vigilant, and be focused on recording what you eat (to make sure your carb and protein intake are correct).

Susan answered, “White bread is so refined that the nutrients are stripped down, again it’s a simple carbohydrate where when a diabetic eats something, there blood sugar will rise and you get a boost of energy. This is the difference between a whole grain and a white-refined bread, once you consume that bread your blood sugar will rise for a little while and you’ll feel energized but the whole grain has better effect on your blood sugar, sustaining that energy over a longer period of time, avoiding the ‘crash and burn’ some feel when eating white bread. Keep in mind that in white bread all of the nutrients have been processed out of the food.” The other difference, you can literally, “Taste the difference when you eat one over the other.”


From an outpatient clinic, we recruited 28 overweight participants with type 2 diabetes for a 16-week single-arm pilot diet intervention trial. We provided LCKD counseling, with an initial goal of <20 g carbohydrate/day, while reducing diabetes medication dosages at diet initiation. Participants returned every other week for measurements, counseling, and further medication adjustment. The primary outcome was hemoglobin A1c.

The DASH diet was created when researchers were looking for ways to effectively reduce hypertension, but this was over 20 years ago! Though it’s still often marketed as a treatment for high blood pressure, the DASH eating plan is really an ideal way to eat for overall health, weight maintenance, and chronic disease prevention. In fact, studies suggest that DASH lowers risk for heart disease, type 2 diabetes and metabolic syndrome, and some cancers.
Early studies reported high success rates: in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (what is known as a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).[18]

Lectins are another way plants defend themselves. Food naturally wears and tears your gut lining as it passes through. The normal repair process is part of the digestion program. Lectins interfere with the repair by binding to the lining of your gut and blocking healing.[17][18] This leaves microscopic holes in the gut, which allows undigested food particles to pass through, and then you find yourself constantly afflicted with low-level inflammation.

Insulin is released in the blood and used to control blood sugar levels including signaling the liver to stop producing sugar. If this system is impaired and the body does not use insulin properly, which is called insulin resistance, individuals are likely to develop high blood sugar levels. In this study the researchers showed that for ketogenic diets this process for controlling blood sugar levels does not work properly and there was insulin resistance in the liver. When the liver is unable to respond to normal levels of insulin to control blood sugar levels this may lead to an increased risk of Type 2 diabetes.

"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.
Control Your Environments. Another simple strategy to help cut calories is to control your environment -- everything from stocking your kitchen with lots of healthy options to choosing the right restaurants. That means avoiding the temptation by staying away from all-you-can-eat restaurants. And when it comes to parties, "eat a healthy snack before so you won't be starving, and be selective when you fill your plate at the buffet," suggests Ward. Before going back for more food, wait at least 15 minutes and have a big glass of water.
In 1993 Oldways created the Mediterranean Diet Pyramid – in partnership with the Harvard School of Public Health and the WHO – as a healthier alternative to the USDA’s original food pyramid. Today, the Mediterranean Diet is more popular than ever, with new research every month documenting its benefits, and chefs and home cooks alike embracing Mediterranean ingredients and flavors. Starting at the base of the pyramid, you’ll find:
Lectins are another way plants defend themselves. Food naturally wears and tears your gut lining as it passes through. The normal repair process is part of the digestion program. Lectins interfere with the repair by binding to the lining of your gut and blocking healing.[17][18] This leaves microscopic holes in the gut, which allows undigested food particles to pass through, and then you find yourself constantly afflicted with low-level inflammation.
Like a marathoner stretching before the big run, eating half a grapefruit before a meal can enhance your body’s fat-burning performance. A study published in the journal Metabolism found that this “warm-up” tactic can help whittle your middle—by up to an inch—in just six weeks! The scientists attribute the powerful effects to the grapefruits’ fat-zapping phytochemicals. The fruit can interact negatively with certain medications, so as long as you get the green-light from your M.D, plan to have half of a grapefruit before your morning meal and add a few segments your starter salads to reap the benefits.

Basically, the effect of exercise on our weight is vastly overrated. That’s why it’s only number 15 on this list. There are other things you need to take care of first. It’s not a good idea to eat bad food, drink sugar water (so-called “sports drinks”) or be on medications which force you to exercise for hours daily just to compensate. Metaphorically that’s like digging a hole, into which you put your ladder, on which you stand and paint the basement-level windows of your house.
“A little forethought can go a long way,” says Monica Auslander Moreno, MS, RD, LDN, consultant at RSP Nutrition. “In my practice I help clients stay on track with weekly meal prep planning guides or prep survival kits. If you fail to plan, you plan to fail,” she explains. By planning your meals in advance, you're less likely to give into temptation or consume extra calories from hidden oils, sugar, and sodium in many take-out dishes.
Con: Results can vary depending on how much fluid you drink. By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. The strips don’t show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you’re in ketosis.
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