A slew of articles in recent months have referred to the ketogenic diet as a “fad” or “trend.” It’s “dangerous,” claimed one article, and an anonymous post by the Harvard Public School of Public Health said the diet “comes with serious risks.”1 Yet strangely, these critics seldom cite scientists or doctors who work with the diet, and many—including the Harvard article—cite no medical literature to substantiate their allegations. Without substantiation, many simply rehash long-contradicted, outdated claims.
WOW. I guess I must be a very special, highly motivated patient then. I, of course, would never have said that about myself. My high motivation is trying to get over the hatred of food that being Diabetic gave me. I don’t feel that way anymore, and am finally happy cooking, again. (My doctor DID tell me exactly that, BTW. Even to the extent of telling me to not include the tsp of agave that I was having in my coffee once a day because sugar is sugar.)
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.
I'm going to give the DASH diet a try. It sounds easy enough but haven't actually tried it yet. I enjoyed the book and am anxious to start the plan. I don't necessarily agree with the artificial sweeteners used. The book does have some good recipes that I want to try. I do think it's a good basic diet that you can adapt to fit your likes and needs. And as always including exercise with a diet will always help. This will hopefully help to accomplish one of my goal for the new year.
The ketone bodies are possibly anticonvulsant; in animal models, acetoacetate and acetone protect against seizures. The ketogenic diet results in adaptive changes to brain energy metabolism that increase the energy reserves; ketone bodies are a more efficient fuel than glucose, and the number of mitochondria is increased. This may help the neurons to remain stable in the face of increased energy demand during a seizure, and may confer a neuroprotective effect.[55]
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Meal planning also causes you to look at your calendar and consider everyones schedule. Grocery shopping can again become part of the family routine with everyone contributing to the meal. You’ll also notice a change in your weekly food budget. Susan pointed out that she had, “Given a presentation on the cost of buying food and cooking meals at home saved $1,200 a year versus eating out. Eating out on average costs people about $2,000 a year. Yes, there are some up front costs when buying the spices or equipment you may need but the second time you go to use them, you are saving instead of spending.”

A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed; 24% occasionally prescribed the diet as a last resort; 24% had only prescribed the diet in a few rare cases; and 16% had never prescribed the diet. There are several possible explanations for this gap between evidence and clinical practice.[33] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[30]
A: You’ll find a detailed menu earlier in this article (also, recipes from Everyday Health!), but generally, you’ll want to make plants and whole grains the stars of your plate. If you look at a Mediterranean diet food pyramid, sweets are up top (indicating they should make up only a small part of your diet), followed by meat and dairy, and then fish. Last are fruit, veggies, and whole grains (suggesting they can be eaten liberally). Also, enjoying food with friends and family is a tenet of the eating approach, so make your meals a social affair!
Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?
Now, I know what you are going to say, “I can take a break from the diet anytime.” What do you think happens when you take that “break”? As soon as you start consuming a normal amount of carbohydrates again, you immediately go out of ketosis or the fat burning state, and your body starts storing fat again immediately. In other words, you immediately start gaining weight. So whatever weight you lost on the diet, you gain back right away. How healthy do you think it is for your body to be in a starvation mode, then in a feeding frenzy, making up for lost time?
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.
Another study, published in the New England Journal of Medicine in 2008, assigned 322 moderately obese adults to one of three diets: calorie-restricted low-fat; calorie-restricted Mediterranean; and non-calorie-restricted low-carb. After two years, the Mediterranean group had lost an average of 9 7/10 pounds; the low-fat group, 6 4/10 pounds; and the low-carb group, 10 3/10 pounds. Although weight loss didn't differ greatly between the low-carb and Mediterranean groups, both lost appreciably more than the low-fat group did.
We have all heard of essential fatty acids (EFAs) and essential amino acids (EAAs), but have you ever heard of essential carbohydrates? No. The human body is capable of burning fat for fuel. If the body can burn fat for fuel, why would you ingest a substance (carbohydrate) that raises your blood sugar, raises your insulin levels, and makes you sick? Why would the ADA advocate the very diet that made us sick in the first place? When are they going to admit they’ve been wrong and start doing what is in the best interest of diabetics?

Finally, people eat about nine servings of fruits and vegetables a day on a Mediterranean diet. (1) Produce packs an array of disease-fighting antioxidants, and people who fill their diet with these foods have lower risk of disease. Yet as the National Institutes of Health points out, it’s not known if it’s the antioxidants or other compounds (or general healthy eating patterns) that are responsible for these advantages. (5)

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.
Popularized by the documentary Forks Over Knives, the Ornish diet is a low-fat, plant-based diet plan based on whole grains, vegetables, fruits, and legumes. It's based on a lacto-ovo style of vegetarianism, allowing only egg whites and nonfat dairy products. It's packed with vitamins, fiber, and lots of filling plants to keep you satiated. Some studies have shown it can reverse heart disease and have beneficial effects on other chronic health conditions. (BTW, there is a difference between a vegan diet and a plant-based diet.)
Y. Wady Aude, MD; Arthur S. Agatston, MD; Francisco Lopez-Jimenez, MD, MSc; Eric H. Lieberman, MD; Marie Almon, MS, RD; Melinda Hansen, ARNP; Gerardo Rojas, MD; Gervasio A. Lamas, MD; Charles H. Hennekens, MD, DrPH, “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat,” Arch Intern Med. 2004;164(19):2141-2146. http://archinte.jamanetwork.com/article.aspx?articleid=217514.
Dr. O’Brien proclaimed that the benefits of the Mediterranean diet as a push away from using animals as a protein source, introducing more fruits and vegetables in meals, while also cutting out butter in favor of using oils cooking. It seemed simple which made me skeptical. I know that in dieting nothing good is easy. When I got back to office I started my research and was surprised to learn that the Mediterranean diet was endorsed by the American Heart Association and Mayo Clinic.

As always, I encourage you to speak to your own doctor about whether or not this diet may be right for you. And, if you decide to go for it, be sure to check in with your doctor regularly to make sure your body is responding well. Those patients who do respond well to the diet will be rewarded with less symptoms and may even be able to completely get off of their medications.


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.
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.
We all have different meanings for “quality of life” for me it means feeling good, with energy, no bloating, no heartburn, on my weight, normal glucose levels… for you it means having “white stuff” to eat, enjoy it while you eat it and then feeling bad about it, ’cause if you’re a diabetes educator you know (or at least you should) the harm it does to your body! I’m glad no one believed this biased article! It means everyone out there know what is real and what is not…
And right up there on the FF list—weight loss. Sure, slow and steady may win the race, but who wants to plod along like a tortoise, especially when a warm weather getaway is right around the corner? Add these 7 super weight loss foods to your day to get your weight-loss goals on hyperspeed. All of them have been scientifically proven to fry flab in 6 weeks or less! Tighten your seatbelt—in fact, you’ll soon be tightening every belt!
When it comes to managing diabetes, it is reasonable that reducing carbohydrate intake can help to lower and stabilize blood glucose levels. The positive effects of the ketogenic diet on diabetes control have been demonstrated in animal models, as well as in humans. We recently reported on several studies that demonstrated substantial metabolic benefits.
I am in the uk and a diagnosed t2d. I am also a nurse, although I am in end of life care. Up until my diagnosis I am ashamed to say the I believed in exactly th.e same things as the writer of this article. Our health service actively promotes a carb rich diet for t2d. Not an excessive amount of calories, but a “healthy” amount of whole grains, fruit, whole rice etc. It was not until I did some actual research and looked at the science that I came to see that what I had been taught and what I really did believe to be the best advice was quite simply wrong.
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.
You’ll find that in their meals, they emphasize a plant-based eating approach, loaded with vegetables and healthy fats, including olive oil and omega-3 fatty acids from fish. It’s a diet known for being heart-healthy. (1) "This diet is rich in fruits and vegetables, whole grains, seafood, nuts and legumes, and olive oil," says Nancy L. Cohen, PhD, RD, professor of nutrition at the University of Massachusetts in Amherst. On this plan, you’ll limit or avoid red meat, sugary foods, and dairy (though small amounts like yogurt and cheese are eaten).

While reading the weekly meal plans I could close my eyes and picture enjoying the tastes of these dishes while soaking in the awesome summer weather on the patio with my girlfriend, with a glass of my favorite California red wine. “The diet also recommends four ounces of red wine in the evening with your meal. Red wine contains flavonoid which helps reduce your risk of developing cardiovascular disease. That’s my favorite part,” shared Susan.
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.

Hi, Esther! Thank you so much for your kind comment. I am so glad you found The Mediterranean Dish and hope you’ll enjoy cooking some of the recipes here! I should preface my answer here by saying that I am not a dietitian or a nutritionist, what I share here is mainly from my experience as someone who grew up in the Mediterranean area and have continued to eat the Mediterranean way now as an adult living in the USA. So please always check with your health care provider or a registered dietitian if you are looking for professional advice or a specific diet plan to follow. But I’ll answer your questions as best as I know how.

If you are pregnant or are nursing, you should not follow a Ketogenic diet. You will not receive enough of the recommended carbohydrates, vitamins and nutrients necessary for yourself and your growing baby on this diet. Your obstetrician will recommend how many carbohydrates you should consume per meal and for snacks during each phase of your pregnancy. They will likely refer you to a Certified Diabetes Educator for nutritional counseling as well. Please check out The Diabetes Council’s FAQ’ About Gestational Diabetes for all your gestational diabetes related questions.

There are theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child's meal. In many countries, food labelling is not mandatory so calculating the proportions of fat, protein and carbohydrate is difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.[53]

It is important to understand that the statement that carbohydrates are “nonessential” is not only factually inaccurate, it results in adopting a low-carbohydrate diet or ketogenic diet that increases your risk for a wide variety of chronic health conditions that may ultimately shorten lifespan, decrease your quality of life, and accelerate your risk for chronic disease.


But the best part about the Mediterranean diet isn't that it's a concrete plan or dedicated to helping you drop pounds; rather, it's a way of eating that incorporates healthy fats, lots of fresh produce, and whole grains. Translation: You can do it for your entire life and never feel like you're actually dieting. (In fact, studies show you can lose weight on the Mediterranean diet without cutting any calories.)

A keto diet has shown to improve triglyceride levels and cholesterol levels most associated with arterial buildup. More specifically low-carb, high-fat diets show a dramatic increase in HDL and decrease in LDL particle concentration compared to low-fat diets.3A study in the long-term effects of a ketogenic diet shows a significant reduction in cholesterol levels, body weight, and blood glucose. Read more on keto and cholesterol >
A slew of articles in recent months have referred to the ketogenic diet as a “fad” or “trend.” It’s “dangerous,” claimed one article, and an anonymous post by the Harvard Public School of Public Health said the diet “comes with serious risks.”1 Yet strangely, these critics seldom cite scientists or doctors who work with the diet, and many—including the Harvard article—cite no medical literature to substantiate their allegations. Without substantiation, many simply rehash long-contradicted, outdated claims.
A relatively new offering, the Nutritarian diet is based on maximizing the amount of healthy vitamins, minerals, and trace nutrients in your food, balancing your hormones, and avoiding toxins. The plan—created by Joel Fuhrman, M.D., author of The End of Dieting—is nutrient-dense, plant-rich, and includes anti-cancer superfoods to help you not just lose weight but live a long, disease-free life. (P.S. Follow these guidelines to make sure you're absorbing all the nutrients from your food.)

Results of meta-analysis of 12 large studies conducted between 1966 and 2008, covering more than 1.5 million subjects, were published in the British Journal of Nutrition in 2009. The authors concluded that the Mediterranean diet is associated with significant health benefits, including lower mortality overall, and reduced risk of chronic diseases like heart disease, cancer, Alzheimer’s and Parkinson’s.
A majority of the meal planning for the Mediterranean diet consists of fresh fruits and vegetables. A sample days meal menu consists of: a pumpkin-gingerbread smoothie for breakfast, Macaroni with Milk (Macoroni oil-Hali) for lunch, and Trout with Wilted Greens for dinner. Your suggested snacks during the day: Mango-Pear Smoothie, cashews and raisins, low-fat ricotta cheese with peaches, hummus, and seed and nut snack bars.
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Perhaps the biggest thing that holds people back from following DASH is approaching it with an “all-or-nothing” attitude. However, DASH does not fall under the common “diet” approach of following an eating plan for a few weeks and then returning to your old way of eating. After all, no one’s diet is perfect. Like the Mediterranean Diet, the DASH diet is best viewed as a healthy way of living and eating. Making small, gradual changes in your food choices—and food quality—can help you form healthier habits for life.
During the 1920s and 1930s, when the only anticonvulsant drugs were the sedative bromides (discovered 1857) and phenobarbital (1912), the ketogenic diet was widely used and studied. This changed in 1938 when H. Houston Merritt, Jr. and Tracy Putnam discovered phenytoin (Dilantin), and the focus of research shifted to discovering new drugs. With the introduction of sodium valproate in the 1970s, drugs were available to neurologists that were effective across a broad range of epileptic syndromes and seizure types. The use of the ketogenic diet, by this time restricted to difficult cases such as Lennox–Gastaut syndrome, declined further.[10]
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!
DASH stands for "Dietary Approaches to Stop Hypertension." The diet was developed out of a study by the National Institutes of Health after researchers noticed that vegetarians tended to have lower rates of high blood pressure. Understanding that sodium intake affected blood pressure, researchers also believed that these levels may also be impacted by other nutrients in plant-based diets.
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.

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.'


Participants returned every other week for 16 weeks for further diet counseling and medication adjustment. When a participant neared half the weight loss goal or experienced cravings, he or she was advised to increase carbohydrate intake by approximately 5 g per day each week as long as weight loss continued. Participants could choose 5 g carbohydrate portions from one of the following foods each week: salad vegetables, low-carbohydrate vegetables, hard or soft cheese, nuts, or low-carbohydrate snacks. Diabetes medication adjustment was based on twice daily glucometer readings and hypoglycemic episodes, while diuretic and other anti-hypertensive medication adjustments were based on orthostatic symptoms, blood pressure, and lower extremity edema.

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.
The keto lifestyle sounds daunting, but it really is not. One thing many fail to mention is the hormonal shifts that occur that regulate your appetite. Give this a little time, and you will be astounded at how easy it becomes to pass on the stuff you found addictive previously. There are many factors that influence one’s success or failure, and the key is to get the information and support you need, and to stick with it long enough to see the benefits. I fine this way of eating completely sustainable, and I’m in for life.
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.
While we’re on the subject of water, why not throw a few lemon slices into the hydrating and satiating beverage? In addition to adding a pop of color and flavor to a tall glass of H2O, lemon can also help encourage weight loss. Just one of the bright citrus fruits contains an entire day’s worth of vitamin C, a nutrient that has the power to reduce levels of a stress hormone called cortisol that triggers hunger and fat storage. Additionally, lemons also contain polyphenols, which researchers say may ward off fat accumulation and weight gain.
As CDE’s, we individualize our recommendations for each of our patients. One person’s diet may not be appropriate for another person. For example, a six foot 6 inch tall man weighing 220 lbs of mainly muscle, who exercises 2 hours per day at the gym cannot have the same number of carbs per meal as a petite 5 foot 1 inch 75 year old lady who does not exercise.

Here’s what we do know: The keto diet may be useful in treating symptoms of epilepsy, a seizure disorder. “The use of keto in treating epilepsy has the most evidence,” Angelone says. One study conducted by Johns Hopkins Medicine, for example, followed epileptic patients on the keto diet and found that 36 percent of them had a 50 percent reduction in seizures after three months on the diet, and 16 percent were seizure-free. However, experts aren't entirely sure why the keto diet has this affect, she adds.
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