From baseline to week 16, the mean body weight decreased significantly from 131.4 ± 18.3 kg to 122.7 ± 18.9 kg, BMI decreased from 42.2 ± 5.8 kg/m2 to 39.4 ± 6.0 kg/m2, and waist circumference from 130.0 ± 10.5 cm to 123.3 ± 11.3 cm (Table ​(Table3).3). The percent change in body weight was -6.6%. The mean percent body fat decreased from 40.4 ± 5.8% to 37.0 ± 6.0%. Systolic and diastolic blood pressures did not change significantly over the 16 weeks. The mean heart rate decreased from 81.2 ± 12.9 beats per minute to 74.6 ± 14.0 beats per minute (p = 0.01).
The ketogenic diet is a mainstream dietary therapy that was developed to reproduce the success and remove the limitations of the non-mainstream use of fasting to treat epilepsy.[Note 2] Although popular in the 1920s and 30s, it was largely abandoned in favour of new anticonvulsant drugs.[1] Most individuals with epilepsy can successfully control their seizures with medication. However, 20–30% fail to achieve such control despite trying a number of different drugs.[9] For this group, and for children in particular, the diet has once again found a role in epilepsy management.[1][10]

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 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.

Fat isn’t unlimited either. As with wine, it's possible to get too much of a good thing when it comes to healthy fats. The American Heart Association points out that while the Mediterranean diet meets heart-healthy diet limits for saturated fat, your total fat consumption could be greater than the daily recommended amount if you aren't careful. That’s 65 g per day. (32)
I think what bothered me most about the article was the way in which the writer has put her own fears about living without cake onto the shoulders of any diabetic she might treat. In the same way an epileptic might choose a life without cake in order to remain seizure free I choose a life without cake to remain “undiabetic”. I must admit that when I was researching this diet I did worry that I would not have the stamina, but the thought of going blind is a useful motivator.
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.)
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.
“Just because the scale isn’t moving, doesn’t mean that you are making zero progress toward your fitness goals and dream body,” explains Mike Roussell, PhD, co-founder of Neutein, a dietary supplement meant to improve memory and performance. “It’s easy to think you’ve hit a plateau when you don’t see additional weight loss on the scale, but that’s not always truly the case."
Case in point, Steve Richert has Type 1 Diabetes and his September 1, 2015 blog The Ketogenic Diet and Type 1 Diabetes: What I Eat. He gave it the good old college try and has fearlessly came back and showed us all his results. His cholesterol increased, which just like mine, was due genetic factors, but was exacerbated by the Ketogenic Diet. So, what’s the best part of Steve’s story? He’s coming close to being right in line with what I would recommend for him! Moderation and the mediterranean diet; he’s currently trying a modified ketogenic diet or really a modified mediterranean diet. Brilliant and exactly what we all should be doing!

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?
With the keto diet, your body converts fat, instead of sugar, into energy. The diet was created in 1924 as a treatment for epilepsy, but the effects of this eating pattern are also being studied for type 2 diabetes. The ketogenic diet may improve blood glucose (sugar) levels while also reducing the need for insulin. However, the diet does come with risks, so make sure to discuss it with your doctor before making drastic dietary changes.
I think the larger question is why we are seeing such a sudden rash of anti-keto stories. So many of them quote no experts sources and do not provide citations for their claims. Skeptics with little acquaintance with the diet are quoted exclusively instead. From a journalistic perspective, this lack of balance of viewpoints and the failure to back up claims with evidence falls below basic reporting standards. Offenders on this list include even the Harvard School of Public Health, which recently published more than one  unsourced, one-sided article on the keto diet (This is in addition to the Lancet Public Health article cited above, by Harvard researchers, which suggests that a low-carb diet kills you). These stories could reflect lazy reporting or they could very well be scare tactics to steer people away from the keto diet.  Why would reporters or scientists at Harvard be doing such a thing? That’s material for another post. Stay tuned.
It seems strange that a diet that calls for more fat can raise “good” cholesterol and lower “bad” cholesterol, but ketogenic diets are linked to just that. It may be because the lower levels of insulin that result from these diets can stop your body from making more cholesterol. That means you’re less likely to have high blood pressure, hardened arteries, heart failure, and other heart conditions. 
Why is the keto diet good for you? A keto diet is one that prioritizes fats and proteins over carbohydrates. It can help reduce body weight, acne, and the risk of cancer. Find out about the mechanisms through which it achieves these benefits and the research that supports it. This MNT Knowledge Center article also discusses the risks of the diet. Read now
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.

I’m not Edward, but I’ve been on a keto diet for 3 weeks. I don’t find it difficult at all. I’ve attended 2 birthday parties, and it’s easy to say “No thank you” when I’m offered cake because my health is my top priority. Drinking a lot of water to support the kidneys is an absolute must. Also, supplementing sodium, potassium and magnesium keeps electrolytes in balance. A Naturopathic doctor is a great source of information on true lifestyle modifications.


Many diets, including Atkins and the keto diet, fit into this umbrella. A typical low-carb diet limits carbs to less than 60 g daily, but this can vary, according to the Mayo Clinic. (15) In a September 2015 review published in PLoS One, people following low-carb diets saw modest weight loss — although study authors note that long-term effects of the diet require further research. (16)

Use fat as a lever.  We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied.


What the diet advocate says: ‘It essentially means scaling your carbohydrate intake up and down in accordance with your activity levels,’ explains performance nutritionist Liam Holmes (phnutrition.co.uk). He uses the principles of nutrient timing to get elite athletes and CrossFit enthusiasts to their leanest before competitions. ‘The body works harder when it doesn’t have carbs as fuel, so it learns to become a more efficient burner of the fuel once it is there.’
“Think outside of the box when you’re preparing what to eat. I wake up every day excited to eat breakfast because I love the foods I've bought and prepared and can't wait to savor them,” Moreno says. Instead of boring oatmeal in the morning, which Moreno calls, “Oliver Twist food,” jazz it up. “Try oatmeal with vanilla protein powder, walnuts toasted in ghee, and cinnamon, that’s much more exciting.”
A low carb diet plan is a way of eating that is high in fat, moderate in protein and low in carbohydrates. There are different variations of low carb, and the keto diet is a special type of low carb with added characteristics. The number of carbohydrates will vary depending on your insulin tolerance and activity level, but on average, these are the common numbers of carbs:
What the diet guru says: ‘Every phase of the New Atkins plan is based on proven scientific principles and is a completely safe, natural way to lose weight,’ say Akins Nutritionals Inc. ‘Phase one is about transforming your body into a fat burning machine and kickstarting your weight loss. By limiting the amount of carbs you eat to around 20g a day, your body will switch its main fuel source from carbs to fat.’
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.
Cortisone as an oral drug is another common culprit (e.g. Prednisolone). Cortisone often causes weight gain in the long run, especially at higher doses (e.g. more than 5 mg Prednisolone per day). Unfortunately, cortisone is often an essential medication for those who are prescribed it, but the dose should be adjusted frequently so you don’t take more than you need. Asthma inhalers and other local cortisone treatments, like creams or nose sprays, hardly affect weight.
We are just two days into 2019, but already the best diet of the year has been named. US News and World Report listed the Mediterranean diet as the best overall diet for 2019 after evaluating 41 of the most popular diets. It was also named best diabetes diet, best diet for healthy eating, best plant-based diet, best heart-healthy diet, and easiest diet to follow.
Swanson, a professor of neurology who has researched the impacts of ketogenic diets on inflammation in the brain, got curious about the ketogenic diet when trying to treat the inflammation that persists for days after a person suffers a stroke. When he tried inducing a ketogenic state in mice with stroke injuries, he said, “I was overwhelmed by the effect.” Blocking glucose metabolism worked to suppress inflammatory genes, which in turn helped stroke healing.
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Keto Diet is NOT strictly 20 grams of carbs per day. Not only are you biased but you are not being truthful. 20 grams per day is just the recommended guideline for maintaining ketosis. Many people can consume 40, 50 even 60 and 70 grams of carbs per day and stay in ketosis. It depends on the person. Age, size lifestyle and exercise all factor into how many carbs can be allowed and maintain ketosis. It is ok to not recommend a diet but when you leave out important aspects you do both your readers and yourself an injustice. Don’t base your article on one or two 3 page leaflets you read on ketosis written 20 years ago.
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.
Remember that on some days, you may eat a few more or a few less servings than recommended for a particular food group. That's generally OK, as long as the average of several days or a week is close to the recommendations. The exception is sodium. Try to stay within the daily limit for sodium as much as possible. Also note that the values for nutritional information may vary according to specific brands of ingredients you use or changes you make in meal preparation.
Both groups experienced no notable adverse effects in their health. In the 29 subjects who successfully completed the calorie-restricted diet, researchers observed an average 16% reduction in fasting glucose, 2.7 reduction in BMI, and loss of 6.9 kg of bodyweight. [9] However, in the 21 subjects that successfully completed the very-low carbohydrate ketogenic diet, subjects experienced an average 19.9% reduction in fasting glucose, 3.9 decrease in BMI, and loss of 11.1 kg of bodyweight. [9]
For people with Type 1 Diabetes, you probably have heard of their diabetic emergency, diabetic ketoacidosis, also referred to as DKA. This can be life threatening condition for people with Type 1 diabetes and Certified Diabetes Educators spend many hours teaching preventive care for DKA. This condition should not be confused with nutritional ketosis, the fat burning state reached when following the Ketogenic diet. The two conditions are quite different.
We’ve now arrived at tip number 16. If you’re still having trouble losing weight, despite following the 15 pieces of advice listed above, it might be a good idea to bring out the heavy artillery: optimal ketosis. Many people stalling at weight plateaus while on a low-carb diet have found optimal ketosis helpful. It’s what can melt the fat off once again.

The DASH diet plan focus on increasing vegetables, fruits, whole grains, and legumes; choosing lean meats, low-fat dairy, nuts and healthy fats; and limiting added sugars, trans fats, added salt, and processed foods. Serving sizes from each food group are based on individual calorie needs (see below for a 1600-calorie plan), and you’ll likely find that the plan looks pretty close to the MyPlate plan, as well as another consistently rated “top diet,” the Mediterranean Diet. Here’s a breakdown of the recommended nutrients in a typical day and week on the DASH diet:
At the conclusion of the intervention, both groups had improved in all metrics but “these changes were more significant in subjects who were on the LCKD as compared with those on the LCD.” [10]. As a result, the researchers supported the study outlined above and concluded that their “…study shows the beneficial effects of a ketogenic diet over the conventional LCD in obese diabetic subjects.” [10]
At the end of this 12 week study, scientists observed similar loss in body fat and overall body weight in all three diets. However, they noted that the VLCARB ketogenic diet was “more effective in improving tracylglycerols, HDL cholesterol, fasting and post-meal glucose and insulin concentrations. More specifically, triacylglycerols decreased by 39.9% in VLCARB subjects, 4.0% in VLF subjects, and 9.6% in HUF subjects. [11]
When you eat foods high in carbohydrates and fat, your body naturally produces glucose. Carbohydrates are the easiest thing for the body to process, and therefore it will use them first – resulting in the excess fats to be stored immediately. In turn, this causes weight gain and health problems that are associated with high fat, high carbohydrate diets (NOT keto).

While studies have demonstrated the weight-loss benefits of the diet, Grandl says, several recent studies that apply more rigorous research techniques to study insulin resistance have suggested detrimental effects. The new study, published in August 2018 in the Journal of Physiology, aimed to better understand the basic biological processes that contribute to the development of type 2 diabetes and the early effects of the ketogenic diet. What people eat impacts the release of glucose, or sugar, in the bloodstream. High glucose levels can, over time, cause insulin resistance. Insulin is the substance released in the body to help manage and regulate sugar in the blood at healthy levels.

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.


Also recognizing what worked 6 months to 1 year ago may not work today. Our bodies change over time and we have to adapt to those changes. So many factors affect your blood glucose levels; you will face hormonal changes, stress related changes, and your pancreas may not be working as well today as it did a year ago and we wouldn’t expect it to. Just as the heart of an 18 year old person is much stronger than it will be at the age of 50 years of age, your pancreas’ function will decline with age with the normal aging process. Many of my patients throughout the years have came to me feeling so defeated because now they have to go on medication or insulin. They are so relieved to hear this may not be due to anything they have caused by overeating or weight gain, it may be just the unfortunate natural progression of diabetes. Until we discover cures for the different types of diabetes, this is what we face.
The Mediterranean diet isn’t a regimented plan, like South Beach, the Blood Type Diet or any others; it’s more a way of eating. After World War II, researchers began studying the eating patterns of 13,000 middle-aged men in the US, Japan, Italy, Greece (including Crete), the Netherlands, Finland and Yugoslavia. They noticed that those in countries whose diets had been restricted by the deprivations of the war had lower rates of heart disease compared to American men. Moreover, residents of Crete enjoyed the best cardiovascular health, leading scientists to conclude that their diet — fruits, vegetables, grains, legumes and fish — played a major role.

In 3 months, I have lost 23 pounds, gone down 5 points in my body fat percentage, and lost 4.5 inches from my waist...after struggling with my weight for decades. (I received a copy of the of the plan guidelines and sample menus in September through the author's Facebook group.) In addition to the outer changes, my cholesterol level dropped to 121, with a commensurate reduction in triglycerides and LDLs.
In its 2016 report “Healthy Eating Guidelines & Weight Loss Advice,” the Public Health Collaboration, a U.K. nonprofit, evaluated evidence on low-carbohydrate, high-fat diets. (The Keto diet falls under the LCHF umbrella.) Among 53 randomized clinical trials comparing LCHF diets to calorie-counting, low-fat diets, a majority of studies showed greater weight loss for the Keto-type diets, along with more beneficial health outcomes. The collaboration recommends weight-loss guidelines that include a low-carbohydrate, high-fat diet of real (rather than processed) foods as an acceptable, effective and safe approach.
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