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Bueno NB, de Melo ISV, de Oliveira SL, da Rocha Ataide T; “Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomized controlled trials” (2013) British Journal of Nutrition 110(7): 1178-1187. Accessed 4/23/2018 https://www.cambridge.org/core/services/aop-cambridge-core/content/view/6FD9F975BAFF1D46F84C8BA9CE860783/S0007114513000548a.pdf/verylowcarbohydrate_ketogenic_diet_v_lowfat_diet_for_longterm_weight_loss_a_metaanalysis_of_randomised_controlled_trials.pdf
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 Without substantiation, many simply rehash long-contradicted, outdated claims.
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.
A computer program such as KetoCalculator may be used to help generate recipes.[46] The meals often have four components: heavy whipping cream, a protein-rich food (typically meat), a fruit or vegetable and a fat such as butter, vegetable oil or mayonnaise. Only low-carbohydrate fruits and vegetables are allowed, which excludes bananas, potatoes, peas and corn. Suitable fruits are divided into two groups based on the amount of carbohydrate they contain, and vegetables are similarly divided into two groups. Foods within each of these four groups may be freely substituted to allow for variation without needing to recalculate portion sizes. For example, cooked broccoli, Brussels sprouts, cauliflower and green beans are all equivalent. Fresh, canned or frozen foods are equivalent, but raw and cooked vegetables differ, and processed foods are an additional complication. Parents are required to be precise when measuring food quantities on an electronic scale accurate to 1 g. The child must eat the whole meal and cannot have extra portions; any snacks must be incorporated into the meal plan. A small amount of MCT oil may be used to help with constipation or to increase ketosis.[36]
Similar to our results, three studies noted that diabetes medications were reduced in some participants[6,8,9], although details were provided in only one study. We also discontinued diuretic medications during diet initiation because of concern for additional diuresis incurred by the diet. This concern was based on the theoretical effects of the diet [17], observed effects of the diet on body water by bioelectric impedance [18], and practical experience with the diet [19]. Until we learn more about using low carbohydrate diets, medical monitoring for hypoglycemia, dehydration, and electrolyte abnormalities is imperative in patients taking diabetes or diuretic medications.
Although adding an exercise routine to your diet overhaul will help you burn fat more quickly than a dietary intervention alone, one JAMA study found that obese patients who change their diets first and begin exercising six months after their diet change will lose the same amount of weight after 12 months as those participants who eat healthier and exercised over the course of the whole year. In short: don’t put off your weight loss goals just because you don’t want to exercise. Change your diet today, exercise later, and you can still lose weight.

“The alkaline diet often has a focus on eating lots of fresh produce and unprocessed foods, which could be a good thing,” says Hultin. “However, keep in mind that this is not an evidence-based therapeutic diet. When people take it too far — for instance, drinking baking soda — or become too restrictive or obsessive over food choices, it can definitely turn negative.”
Ben Tzeel is a Registered Dietitian and Certified Strength and Conditioning Specialist (CSCS), holding a Masters in Nutrition from the University of North Carolina at Chapel Hill. Ben has lived with Type 1 Diabetes since 1999 and has never allowed it to hold him back from achieving his goals. He is a published fitness model and author who writes about exercise, nutrition, and diabetes.
The 2019 rankings include 41 of today’s most popular diets. New to the list this year is the Nordic Diet, a plant-heavy eating plan that incorporates Scandinavian traditions and ranked 9th best overall. Here’s how the rest of the rankings shook out this year, and what experts have to say about the good, the bad, and the trendy. (Here’s a hint: They’re still not crazy about keto.)
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Gary D. Foster, Ph.D., Holly R. Wyatt, M.D., James O. Hill, Ph.D., Brian G. McGuckin, Ed.M., Carrie Brill, B.S., B. Selma Mohammed, M.D., Ph.D., Philippe O. Szapary, M.D., Daniel J. Rader, M.D., Joel S. Edman, D.Sc., and Samuel Klein, M.D., “A Randomized Trial of a Low-Carbohydrate Diet for Obesity — NEJM,” N Engl J Med 2003; 348:2082- 2090. http://www.nejm.org/doi/full/10.1056/NEJMoa022207.

Think of each almond as a natural weight-loss pill. A study of overweight and obese adults found that, combined with a calorie-restricted diet, consuming a little more than a quarter cup of the nuts can decrease weight more effectively than a snack comprised of complex carbohydrates and safflower oil—after just two weeks! (And after 24 weeks, those who ate the nuts experienced a 62% greater reduction in weight and BMI!) For optimal results, eat your daily serving before you hit the gym. A study printed in The Journal of the International Society of Sports Nutrition found that almonds, rich in the amino acid L-arginine, can actually help you burn more fat and carbs during workouts. Fill up, but don’t fill out: Use these Eat This, Not That!-recommended 10 Daily Habits That Blast Belly Fat.
2- Eat more vegetables, fruits, grains, and legumes. The base of the Mediterranean diet pyramid should make up the base of every meal. When you can, opt for vegetarian entrees like this Cauliflower and Chickpea Stew;  Spicy Spinach and Lentil Soup; or Spanakopita (Greek Spinach Pie). Rely more on satisfying, flavor-packed salads to make up a good portion of your plate. Some ideas: Kindey Bean Salad; Mediterranean Chickpea Salad; Greek Salad; Bean and Lentil Salad.
Have Protein at Every Meal and Snack. Adding a source of lean or low-fat protein to each meal and snack will help keep you feeling full longer so you're less likely to overeat. Try low-fat yogurt, small portion of nuts, peanut butter, eggs, beans, or lean meats. Experts also recommend eating small, frequent meals and snacks (every 3-4 hours), to keep your blood sugar levels steady and to avoid overindulging.
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…
Hi Stacey, I can’t give medical advice and definitely recommend following your doctor’s recommendations. You can ask him/her if low carb would be better suited for you. Also, you may want to double check with him/her if the kidney concern was related to high protein, because that is a common misconception about keto – it is not a high protein diet/lifestyle.
After initiation, the child regularly visits the hospital outpatient clinic where he or she is seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks.[9] A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian[18] and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet.[3] Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect.[18] This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).[44]
Great article! Sustainability is key and Keto diet is extremely restrictive compared to others. Many of the comments I see don’t understand the importance of many years of research before stating something has a “significant difference” than the recommendations that are already in place. Also, understanding the pro/carb/fat balance in each meal instead of focusing on just carbohydrates. We have practiced the same modified Mediterranean diet at my practice where someone can enjoy life, eat complex carbohydrates and years later they are still successful and hundreds of pounds have been lost for good 🙂 Thank you for the reminder (and the comparison of Adkins supported research).

One of the keto researches commented, (I think it was Steve Phinney) that change will come about only because enough of the the public will be become educated about this and will demand that the ADA change their recommendations because those recommendations are just wrong. What is the proof they are wrong? If you eat 45-60 g of carb daily, you will continue to have diabetes, and the epidemic will continue as it has for the last 25 years.
The truth is though, her reaction is part of the problem. “I can’t believe your numbers improved so drastically without taking the medication.” THAT is the main problem with our medical community. They have been taught, and most have bought into the lie, that everything is better with medication. Medication is the go to. That is why we have so many health issues in this country. Let’s eat a crappy diet because our government/medical community recommends it…and then when that diet leads to medical complications…let’s throw drugs/medication at it. Many, if not the majority, of the medical issues we have could be done away with if we actually ate as we should. But no…we want cake.
The ketogenic diet is not a benign, holistic or natural treatment for epilepsy; as with any serious medical therapy, there may be complications.[27] These are generally less severe and less frequent than with anticonvulsant medication or surgery.[27] Common but easily treatable short-term side effects include constipation, low-grade acidosis and hypoglycaemia if there is an initial fast. Raised levels of lipids in the blood affect up to 60% of children[37] and cholesterol levels may increase by around 30%.[27] This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and, if persistent, by lowering the ketogenic ratio.[37] Supplements are necessary to counter the dietary deficiency of many micronutrients.[3]
A woman sitting next to me at jury duty was intently reading this book, so I asked her about it. She recommended it highly - said it was #1 book by U.S. News and World Report, etc. I bought it, read it, and got a lot out of it. It is very similar to the Sonoma Diet, which is the Mediterranean Diet, the most sensible diet I have ever found. I is wound through most of the diet I see these days. Lean, LEAN red meats eaten sparingly, chicken, fish, dried beans, green vegetables, RED fruits and veget ...more
The struggle as a prescriber is that you have to follow the “standard of care,” lest you open yourself up to a lawsuit. So I talk to my patents about what “the” recommendations are, and then I talk to them bout what the evidence says and what my experience says. Plain and simple, patient’s trust the government’s recommendations and can’t wrap their head around the idea of not eating carbs because they have learned their entire lives that the body “needs” carbs to survive.
A woman sitting next to me at jury duty was intently reading this book, so I asked her about it. She recommended it highly - said it was #1 book by U.S. News and World Report, etc. I bought it, read it, and got a lot out of it. It is very similar to the Sonoma Diet, which is the Mediterranean Diet, the most sensible diet I have ever found. I is wound through most of the diet I see these days. Lean, LEAN red meats eaten sparingly, chicken, fish, dried beans, green vegetables, RED fruits and veget ...more
WH Verdict: While it’s unlikely to be popular with those who’ve chosen a plant-based lifestyle for ethical reasons, the principal of eating real, whole food is sound. And combining two ways of eating certainly makes it easier to get enough protein and vital nutrients. But it’s still pretty restrictive, so consult a nutrition professional to make sure you aren’t at risk of nutritional deficiencies.

Blood specimens were obtained at weeks 0, 8, and 16 after the participant had fasted overnight. The following serum tests were performed in the hospital laboratory using standardized methods: complete blood count, chemistry panel, lipid panel, thyroid-stimulating hormone, and uric acid. A non-fasting specimen was also drawn at weeks 4 and 12 to monitor electrolytes and kidney function.

The ketogenic diet is not a benign, holistic or natural treatment for epilepsy; as with any serious medical therapy, there may be complications.[27] These are generally less severe and less frequent than with anticonvulsant medication or surgery.[27] Common but easily treatable short-term side effects include constipation, low-grade acidosis and hypoglycaemia if there is an initial fast. Raised levels of lipids in the blood affect up to 60% of children[37] and cholesterol levels may increase by around 30%.[27] This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and, if persistent, by lowering the ketogenic ratio.[37] Supplements are necessary to counter the dietary deficiency of many micronutrients.[3]


Eating out is possible on the DASH Diet, but proceed with caution. Restaurant meals are notoriously salty, oversized and fatty, so you’ll need to be conscientious if you dine out. NHLBI suggests avoiding salt by shunning pickled, cured or smoked items; limiting condiments; choosing fruits or vegetables instead of soup; and requesting the chef find other ways to season your meal. You can also drink alcohol moderately on the DASH Diet.
I agree!! I too..have /had Diabetes II..at age 66 and retired RN, we were taught for so long the WRONG way to eat and I taught that way, the high carb, grains, etc, way to eat. KETO saved me. Dropped my A1C and I feel great. The author of this page is wrong when saying 5-10 percent of our diet, carb eating, should be root veggies like ‘carrots”…so wrong. For goodness sakes, get KETO right by educating yourself, Tammy Shiflet~ Horribly wrong! There are so many studies and physicians, brain scientists, etc out here who understand what this diet is about. Read, and educate yourself….Please! Diabetes is a symptom of the Government’s education mistakes. Sugar, Wheat, Grains…horrible for us. Get with it, we live in 2018 and the information is out there; if you need a list, just ask.

Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures and kidney stones.[3] The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone.[37] About 1 in 20 children on the ketogenic diet will develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone.[38] The stones are treatable and do not justify discontinuation of the diet.[38] Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in a sevenfold decrease in the incidence of kidney stones.[39] However, this empiric usage has not been tested in a prospective controlled trial.[9] Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:[38]


The cost of the Mediterranean diet, like most aspects of the diet, depends on how you shape it. While some ingredients (olive oil, nuts, fish and fresh produce in particular) can be expensive, you can find ways to keep the tab reasonable – especially if you're replacing red meats and meals with plant-based home cooking, some research suggests. Your shopping choices matter, too. Can't spring for the $50 bottle of wine? Grab one for $15 instead. And snag whatever veggies are on sale that day, rather than the $3-a-piece artichokes.
The cost of the Mediterranean diet, like most aspects of the diet, depends on how you shape it. While some ingredients (olive oil, nuts, fish and fresh produce in particular) can be expensive, you can find ways to keep the tab reasonable – especially if you're replacing red meats and meals with plant-based home cooking, some research suggests. Your shopping choices matter, too. Can't spring for the $50 bottle of wine? Grab one for $15 instead. And snag whatever veggies are on sale that day, rather than the $3-a-piece artichokes.
I see several inconsistencies, one being a strict 20 grams or less of carbs, most Keto followers I see aim for closer to 30, and even as high as 40 per day. I also see several times in this article her opinion that you cannot get all of your essential vitamins and minerals without eating fruits, and I’m no nutritionist, but this is far from the truth. The writers hatred for this w.o.e. Presents itself early and often in this article, and because they weren’t able to successfully stay away from sweets, and other carbs, they’re attempting to scare others away as well, especially pregnant women. She admits that she’s been taught to follow the ADA’s dietary guidelines which has been proven to fail. It sadly isn’t working. She recommends consulting your physician before attempting this w.o.e., I tried that and was instructed to follow the clean eating that I had followed for the first 15 years with type 1. The 60 grams of complex carbs in meals, and 20 or so with snacks. That way allowed me to ride a dangerous daily rollercoaster, with damaging highs, and very dangerous lows. Yet my Endo was pleased with my sub 7 a1c, even though I was always tired. I’ve practiced a very healthy way of eating long before being dxd with type 1, which probably makes it easier for me to continue living this way. Ultimately, the info is out there, and those able to avoid certain foods will be rewarded with non diabetic numbers… some say big food/pharmaceutical are doing all they can to end this “fad” I’m not sure if it’s true or not, but the simple fact that there will always be those that lack enough discipline to remain in ketosis should still present them with enough clientele.
Probably, and there are a few reasons why the keto diet usually equals weight-loss gold, says Keatley. For starters, people usually reduce their daily caloric intake to about 1,500 calories a day because healthy fats and lean proteins make you feel fuller sooner—and for a longer period of time. And then there’s the fact that it takes more energy to process and burn fat and protein than carbs, so you're burning slightly more calories than you did before. Over time, this can lead to weight loss.

The remaining calories in the keto diet come from protein — about 1 gram (g) per kilogram of body weight, so a 140-pound woman would need about 64 g of protein total. As for carbs: “Every body is different, but most people maintain ketosis with between 20 and 50 g of net carbs per day,” says Mattinson. Total carbohydrates minus fiber equals net carbs, she explains.
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