The following measurements were made every other week: anthropometric and vital sign measurements; urine testing for ketones; and assessment for hypoglycemic episodes and other symptomatic side effects. Weight was measured on a standardized digital scale while the participant was wearing light clothes and shoes were removed. Skinfold thickness was measured at 4 sites – the average of 2 measurements at each site was entered into an equation to calculate percent body fat [12]. Waist circumference was measured at the midpoint between the inferior rib and the iliac crest using an inelastic tape; 2 measurements were averaged in the analysis. Blood pressure and heart rate were measured after the participant had been seated quietly without talking for 3 minutes. Certified laboratory technicians assessed urine ketones from a fresh specimen using the following semi-quantitative scale: none, trace (up to 0.9 mmol/L [5 mg/dL]), small (0.9–6.9 mmol/L [5–40 mg/dL]), moderate (6.9–13.8 mmol/L [40–80 mg/dL]), large80 (13.8–27.5 mmol/L [80–160 mg/dL]), large160 (>27.5 mmol/L [160 mg/dL]). Hypoglycemic episodes and symptomatic side effects were assessed by direct questioning of the participant and by self-administered questionnaires.
A small Feb. 20, 2017, study looked at the impact of a six-week ketogenic diet on physical fitness and body composition in 42 healthy adults. The study, published in the journal Nutrition & Metabolism, found a mildly negative impact on physical performance in terms of endurance capacity, peak power and faster exhaustion. Overall, researchers concluded, “Our findings lead us to assume that a [ketogenic diet] does not impact physical fitness in a clinically relevant manner that would impair activities of daily living and aerobic training.” The “significant” weight loss of about 4.4 pounds, on average, did not affect muscle mass or function.
The aim is far broader than suggested by the article here: It’s not just about what you put in your mouth – it’s also about timing and exercise. There are three ways to be in ketosis – which simply means that “fat burning” and not being dependent on sugars. Fasting puts a man into ketosis in 3 days and a woman by 2 days. Endurance exercise gets you there in a couple of hours. Eating a high fat diet will do it too. The goal however is hidden by the detail – it is to acquire a “Flexible Metabolism”. The aim is to switch on the full fat burning capacity and keep it running – which takes from between 4 to 12 weeks physical adaptation (for the muscles to fully be able to use ketones). The heart runs approximately 27% more efficiently on ketones than on glucose! The brain works better too – Alzheimer’s being referred to by researchers as “diabetes 3”. Once you have a Flexible Metabolism you can consume carbs during or after exercise without dropping out of ketosis – though this depends on your own bio-individuality. I can eat quite a lot of carbs – without losing ketosis – my partner cannot.
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.
Eat Breakfast Every Day. One habit that's common to many people who have lost weight and kept it off is eating breakfast every day. "Many people think skipping breakfast is a great way to cut calories, but they usually end up eating more throughout the day, says Elizabeth Ward, MS, RD, author of The Pocket Idiot's Guide to the New Food Pyramids. "Studies show people who eat breakfast have lower BMIs than breakfast-skippers and perform better, whether at school or in the boardroom." Try a bowl of whole-grain cereal topped with fruit and low-fat dairy for a quick and nutritious start to your day.
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?
Recently, four studies have re-examined the effect of carbohydrate restriction on type 2 diabetes. One outpatient study enrolled 54 participants with type 2 diabetes (out of 132 total participants) and found that hemoglobin A1c improved to a greater degree over one year with a low-carbohydrate diet compared with a low-fat, calorie-restricted diet [5,6]. Another study enrolled 8 men with type 2 diabetes in a 5-week crossover outpatient feeding study that tested similar diets [7]. The participants had greater improvement in glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet. The third study was an inpatient feeding study in 10 participants with type 2 diabetes [8]. After only 14 days, hemoglobin A1c improved from 7.3% to 6.8%. In the fourth study, 16 participants with type 2 diabetes who followed a 20% carbohydrate diet had improvement of hemoglobin A1c from 8.0% to 6.6% over 24 weeks [9]. Only these latter three studies targeted glycemic control as a goal, and two of these were intensely-monitored efficacy studies in which all food was provided to participants for the duration of the study [7,8]. Three of the studies [6,8,9] mentioned that diabetic medications were adjusted but only one of them provided detailed information regarding these adjustments [9]. This information is critical for patients on medication for diabetes who initiate a low-carbohydrate diet because of the potential for adverse effects resulting from hypoglycemia.

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.
It sounds as if you may have been following a very strict keto protocol. I’m not, and have not followed a ketogenic diet, but am interested in it. I’ve been reading up on it a bit on the blog called Mark’s Daily Apple.* I’ve been following it for several years now, even before Mark tried keto. Based on some of his blog post, both keto related and otherwise, it seems that women do better with slightly more carbs than men. He’s written several blog post specifically for women, including one called 7 Keto Tips for Women, which you may want to read. https://www.marksdailyapple.com/7-keto-tips-for-women/ Then there is this one Where I Part Ways with the Popular Keto Movement https://www.marksdailyapple.com/where-i-part-ways-with-the-popular-keto-movement/ Perhaps the problem wasn’t the keto diet in and of itself, but that you went too low carb for you. It’s worth considering. I’ve also found this site to be pretty interesting https://peterattiamd.com/ Here’s a link to his section on keto https://peterattiamd.com/category/ketosis/ He followed a ketogenic diet for a number of years, though as of 2016 was no longer ketogenic, but definitely eating lower carb than most. (That is under Articles, on the drop down menu, click on Personal.)
You have about 160,000 Kcals of fat available to burn – producing your own glucose in the process when needed (for anaerobic bursts). In contrast you only store around 400 to 500 Kcals of glucose/glycogen ready for use so if you are not adapted to burning fat then you are physically dependent and addicted to eating carbs. When you hear of a runner “hitting the wall” it’s only because of their unnatural carb addiction – an efficient fat burning athlete can run all day and will never have this problem. The human body is specifically designed to run long distance and can outrun almost every other animal on this planet – we can even run though intense heat because we sweat.
On May 24, 2018, I had a 90-day follow-up appointment with my doctor. When he came to the exam room with my chart he immediately started to fist pump me with praise of congratulations, he was ecstatic. I am now at 233 pounds (106 kg)! I have lost 51 pounds (23 kg) and my girlfriend has lost 25 pounds (11 kg). I went from a 42-inch (107 cm) waist to a 38-inch (96 cm) waist. But, here’s the best part, my A1c came down to 5.7 and all my health markers have improved. He called me his poster child for being on the path to curing my Type 2 diabetes.
The Mediterranean diet is rooted in an abundance of fresh plant-based foods including fruits, vegetables, nuts, seeds, beans, and legumes, with olive oil being the primary source of monounsaturated fat. Fish and seafood follow as a primary source of protein with moderate amounts of poultry, dairy, and eggs to follow. Red meat and sugary treats should be consumed relatively rarely and in moderate portions.

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.
There is research that supports the ketogenic diet for diabetes management, while other research seems to recommend opposing dietary treatments like a plant-based diet. Research from 2017 confirms that people with diabetes who followed a plant-based diet experienced significant improvements in blood sugars and A1c, cardiovascular disease risk factors, gut bacteria that is responsible for insulin sensitivity, and inflammatory markers like c-reactive protein.
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.

The other nutritional remedy for T2 diabetes is carbohydrate restriction. In a large, ongoing university-based study, 60% of patients with Type 2 diabetes reversed their diagnosis of diabetes after just one year on a ketogenic diet, supplemented by support via a mobile phone app.11 On this protocol, 94% of participants reduced or eliminated their need for insulin medications while improving the vast majority of cardiovascular risk factors.12


Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject.
Cons: That same study on the perks of being a keto athlete also found those same dieters had a lower exercise economy (how efficiently you use oxygen while moving). And whereas pretty much every other diet offers flexibility in the macro range, eating a few too many grams of carbs or protein will knock your body out of ketosis, so you have to be pretty committed to see the perks of this one. Lastly, the low protein count required to stay in ketosis may be holding you back here: A study analysis in Nutrition, Metabolism, and Cardiovascular Diseases found upping protein on a keto diet by just 5% tripled fat loss.

My Husband and I started doing Keto July 2018. We got over weight after we got out of the Marine Corps. It has been hard to workout because I became disabled, but my diet was not good. After our friend Amber recommended your site and support group, we found a lot of helpful information to get us started on a successful journey. So far it’s been one month and we have lost 18 pounds each!

Forget old low-carb diet plans that focused on processed protein bars and shakes. This year, the keto diet got high marks for low carb. Keto, short for "ketogenic," is all about training the body to burn fat for fuel. How? By eating fat—and lots of it. Most keto diets recommend getting at least 70 percent of your daily calories from fat and the rest from protein. The goal is to eat as few carbohydrates as possible. Proponents say it helps them drop weight fast with little or no hunger in addition to perks like more energy and mental clarity. (Interested? Here's everything you need to know about the keto diet.)
I would just like to share with you that my patients are HORRIFIED if their physicians ask them to cut out “everything white” in their diet. This is what some doctors ask for…essentially asking for the Ketogenic diet and most of my patients are in shock! Not only would I never want to skip a year of my birthday cake, but I wouldn’t ask my patients to either! One slice of cake is certainly not going to harm anyone with diabetes and hopefully you know enough about carbohydrates and their short term effect on BG levels to know this too! I am not a Registered Dietitian, so I couldn’t speak to this diet in regard to children with epilepsy. Are you a Neuro RN? TheDiabetesCouncil did just post another article where 25 Registered Dieticians weighed in regarding the Ketogenic Diet, so I would encourage you all to check that out!
The fad military diet consists of low-calorie, odd food pairings such as bun-less hot dogs with banana, carrots, and broccoli. “Any diet like the military diet that severely limits the amount of calories you consume or eliminates one or more entire food groups puts any individual at risk for nutrient deficiencies,” says Kyle. “This can be more harmful than holding onto those 10 extra lb you’re trying to lose.” (32)
January 6, 2016 "What makes a diet best? In Best Diets 2016, the latest set of exclusive rankings from U.S. News, the DASH diet beat out 37 others.  To be top-rated, a diet had to be relatively easy to follow, nutritious, safe, effective for weight loss and protective against diabetes and heart disease. The government-endorsed Dietary Approaches to Stop Hypertension (DASH) snagged the top spot."
I believe that nature teaches us in wonderful ways about what works. Take the four seasons for example. I’ve adapted a ketogenic way of eating that is a cyclic method. I workout a lot, and a focus of mine is increasing muscle mass and strength. While I wouldn’t be able to maintain and/or increase those two factors with the amount of intense workouts I have, I don’t follow a strict ketogenic “diet”. I go about 3 weeks of being in keto, and then for a couple of days, I eat whatever I want. That means, I can eat cake, cookies, pies, whatever I want, for those two days. I even get to enjoy birthday cake ;). Then after that, I go back to keto. It’s work WONDERS. It’s EXTREMELY maintainable, I’m still loosing weight and achieving my goals. I’ve also been getting better at listening to my body and understanding how certain foods affect my body—which is something we’re not taught. It’s really amazing how we have such intelligent systems that are ALWAYS communicating with us. We just have to understand how to listen to them. Truly. The problem with a lot of our society, is that we are stuck in the high-end of the cyclic, or the feasting mode, and we think it’s normal! Hence the many ailments and medical conditions that keep increasing. The point is, there are many variations of following a ketogenic way of eating, and it DOES require a life-style change. Just like any other recommendation from a dietician or educator.
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.

The following weekend I was looking for a book on this diet at Barnes & Noble in Colonie Center. A title caught my eye, “The Mediterranean Diet Plan,” written by Susan Zogheib. After reading the book’s introduction I quickly skimmed through the background of the diet and stopped at the diet plans. I smiled. I thought to myself, “I could totally do this!” I skipped ahead to the recipes. At that moment I knew I had found my diet plan! The book has four, four-week diet plans complete with recipes for every meal that are structured on the level of comfort you have with making the switch. One month of meals AND recipes, I couldn’t wait!
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!
Want even more inspiration? Sign up for our Fresh Fridays newsletter. Our bi-weekly e-newsletter delivered right to your inbox celebrates the Mediterranean Diet and its remarkable health benefits. Each issue includes delicious recipes that will remind you just how easy it is to enjoy beautiful, simple, economical, and easy-to-find Mediterranean foods. 

Have rest of frittata from Wednesday's breakfast. Serve with 2 cups baby spinach leaves, topped with 2 tablespoons balsamic vinegar, and 1 cup fat-free milk. Have one slice of whole-wheat toast topped with 2 teaspoons light trans-fat-free margarine. For dessert, have one 2-inch-square piece of baklava, a traditional Greek pastry with flaky fillo dough and walnuts. Athens Brand Frozen Baklava Pastry is available in many groceries nationwide. It's a great choice because the portions are tiny, and no baking or heating is required. (Have two squares if choosing Athens brand.)
The other nutritional remedy for T2 diabetes is carbohydrate restriction. In a large, ongoing university-based study, 60% of patients with Type 2 diabetes reversed their diagnosis of diabetes after just one year on a ketogenic diet, supplemented by support via a mobile phone app.11 On this protocol, 94% of participants reduced or eliminated their need for insulin medications while improving the vast majority of cardiovascular risk factors.12
SOURCES: WebMD Feature: "With Fruits and Veggies, More Matters." 2005 U.S. Dietary Guidelines. Elizabeth Ward, MS, RD, author, The Pocket Idiot's Guide to the New Food Pyramids. Elaine Magee, MPH, RD,author, Comfort Food Makeovers. Brian Wansink, PhD, professor and director, Cornell Food and Brand Lab, Ithaca, N.Y.; author, Mindless Eating. Barbara Rolls, PhD, professor of nutritional sciences; and director, laboratory for the study of human ingestive behaviors, Penn State University; and author, The Volumetrics Eating Plan.

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!


This is ALL so confusing and overwhelming. I am not diabetic. I am trying to be proactive about it. I am borderline obese (by US standards) and obese (by Asian standards). I am 50 years old. I was addicted to fat and sugar (especially combined!) through my teens and twenties. I decided to get healthy in my 30s, so I became a Vegan (but an unhealthy/careless one, so my weight yo-yo’ed a lot in my 20s and 30s). In my 40’s I reintroduced animal products into my diet and a number of my health issues went away, but I am still fat. I am considering Keto/Carnivore, but I am concerned that I may just be falling prey to more extreme diets which could set me up for problems (e.g. diabetes) down the road. I guess I am what most would refer to as pre-diabetic (metabolic syndrome). Should I try keto or am I taking too much of a risk?


DASH is based on the following foods: fruits, vegetables, low fat milk, whole grains, fish, poultry, beans, and nuts. It recommends reducing sodium, foods and beverages with added sugars, and red meat. The diet is heart-friendly as it limits saturated and trans fat, while increasing the intake of potassium, magnesium, calcium, protein, and fiber, nutrients believed to help control blood pressure. [1]

Epilepsy is one of the most common neurological disorders after stroke,[7] and affects at least 50 million people worldwide.[8] It is diagnosed in a person having recurrent unprovoked seizures. These occur when cortical neurons fire excessively, hypersynchronously, or both, leading to temporary disruption of normal brain function. This might affect, for example, the muscles, the senses, consciousness, or a combination. A seizure can be focal (confined to one part of the brain) or generalised (spread widely throughout the brain and leading to a loss of consciousness). Epilepsy may occur for a variety of reasons; some forms have been classified into epileptic syndromes, most of which begin in childhood. Epilepsy is considered refractory (not yielding to treatment) when two or three anticonvulsant drugs have failed to control it. About 60% of patients will achieve control of their epilepsy with the first drug they use, whereas about 30% do not achieve control with drugs. When drugs fail, other options include epilepsy surgery, vagus nerve stimulation and the ketogenic diet.[7]
Finally, the ketogenic diet has been shown to be an effective adjuvant for the treatment of certain cancers. The beneficial effects have been demonstrated for various cancer types, including prostate, colon, and brain cancer, such as glioblastoma. Its efficacy has been documented in animal models as well as in humans, including in pediatric patients.
Coffee jumpstarts your metabolism, making the non-decaf stuff a worthy weight loss ally. According to a study published in the journal Physiology & Behavior, the average metabolic rate of people who drank caffeinated coffee was 16 percent higher than that of those who drank decaf. In addition to caffeinating your coffee, it’s also crucial to keep it black and avoid adding any unhealthy creamers and artificial sweeteners, both of which are enemies of weight loss.
“A healthy diet should be a sustainable eating plan that provides adequate nutrition to support optimal health,” Taylor says. “For many people with diabetes, a low-carb diet is a temporary tool that can be used to support short-term weight loss and improved blood sugar control. However, I typically don't recommend sticking with a low-carb diet permanently, as many micronutrient deficiencies can result from an unbalanced eating plan. I like to think of low-carb diets as a possible ‘stepping stone,’ not a ‘forever diet.’”
Also, reducing sodium doesn’t restrict you to boring, bland food, nor does it mean you have to toss out the salt shaker. Yes, reducing the amount of salt you use and choosing lower-sodium products are key, but opting for fresh foods or whole foods instead of boxed, canned, and ready-to-heat items makes a big enough impact. Experiment with spices and herbs, and use a little salt to enhance flavor. Salt should never be the sole flavoring or seasoning in any in dish.
When you're deciding to go on a diet, there are so many options to choose from. You can go keto and focus on healthy fats, try intermittent fasting, or just eat a certain amount of calories a day. One option you might not have tried yet, though, is the DASH diet, which has a simple goal: keeping your body (especially your heart!) as healthy as possible.
The focus of the DASH Diet is more about what you can eat, rather than cutting foods out, like many trendy diets do these days, such as Whole30 and the ketogenic diet, which call to eliminate certain food groups altogether. The basic idea is to load up on fruits and veggies, choose whole grains over refined, include calcium-rich dairy items, and eat modest amounts of lean meat and fish. By including plenty of healthy whole foods each day, you naturally eliminate some of the not-so-great foods (like added sugars and unhealthy fats). With this week's meal plan, we make it even easier to follow the DASH Diet with 7 days of healthy and delicious meals and snacks.
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).
“There are many diet plans on the market today that promote good health,” says Emily Kyle, RDN, who is in private practice in Rochester, New York. “The key is finding one that does not cause you stress or agony.” Ask yourself questions such as: Would the diet guidelines make you happy? Anxious? Stressed? Are you able to follow them long term? “Factors such as enjoyment, flexibility, and longevity should be strongly considered,” adds Kyle.
Also worth noting is that low-carbohydrate, low-GI, and Mediterranean diets led to significant improvements in blood lipids with up to a 4–10% increase in HDL (4% in the Mediterranean, 5% in low-GI, and 10% in low-carbohydrate diets), 1–4% reduction in LDL (1% in low-carbohydrate, 3% in low-GI, and 4% in Mediterranean diets), and 9% reduction in triglycerides. [16]
Before starting, ask yourself what is really realistic for you, Mattinson suggests. Then get your doctor’s okay. You may also work with a local registered dietitian nutritionist to limit potential nutrient deficiencies and talk about vitamin supplementation, as you won’t be eating whole grains, dairy, or fruit, and will eliminate many veggies. “A diet that eliminates entire food groups is a red flag to me. This isn’t something to take lightly or dive into headfirst with no medical supervision,” she says.
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