Wolfrum said he and his colleagues don't want to stop people from changing their diet if that's what's necessary to reach a healthy weight, but they think it's important for people to know that "the [final] verdict on the ketogenic diet is not out yet." There's still more research to be done to fully understand the long-term effects of a high-fat, low-carb diet. In the meantime, said Wolfrum, "more balanced food intake is probably the healthiest way to live."
Yancy WS, Olsen MK, Guyton JR, Bakst RP, Westman EC; “A Low-Carbohydrate, Ketogenic Diet versus a Low-Fat Diet To Treat Obesity and Hyperlipidemia: A Randomized, Controlled Trial” (2004) Annals of Internal Medicine 140(10): 769-777. Accessed 6/4/2018 https://annals.org/aim/fullarticle/717451/low-carbohydrate-ketogenic-diet-versus-low-fat-diet-treat-obesity
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.)
As it turns out, almonds aren’t the only superstar nuts around. Studies have shown pistachios aren’t bad to snack on either. UCLA Center for Human Nutrition researchers divided study participants into two groups, each of which were fed a nearly identical low-cal diet for three months. One group was given 220-calories of pretzels as an afternoon snack, while the other sect munched on 240-calories worth of pistachios. About a month into the study, the pistachio group had reduced their BMI by a point and improved their cholesterol and triglyceride levels, while the pretzel-eaters stayed the same.

The ketogenic diet — or the “keto” diet for short — has been around for decades. Most popularly, doctors have assigned the keto diet to help control seizures in people with epilepsy, according to the Epilepsy Foundation. But in recent years, people have begun turning to the diet in hopes of losing weight and, in some cases, better managing type 2 diabetes. Studies show that metabolic processes are altered when people consume a diet high in fat, such as meat, and low in carbohydrates, such as bread and pasta. The body shifts into a natural metabolic state called ketosis, during which it burns fat rather than carbs for energy, according to a February 2014 review published in the International Journal of Environmental Research and Public Health. Although carb intake varies depending on which version of keto is at hand, people following the plan typically limit the intake of carbohydrates to less than 5 percent of their daily calories, notes the Chicago Academy of Nutrition and Dietetics.
In a second study,2 a Harvard-led research team evaluated the benefit of a ketogenic diet in both children and adults with type 1 diabetes despite concerns about a possible negative effect on growth and development in children following such a restricted diet. These researchers report "exceptional" glucose control with little adverse effects. However, the participants were recruited from a closed Facebook group, TypeOneGrit, for people who follow a diet and diabetes program based on the recommendations in the Diabetes Solution,3 a book by Richard K Bernstein, MD, who devised this program to manage his own type 1 diabetes.
There is a lack of scientific research when it comes to the long-term effects of the keto diet. When it comes to healthy eating and weight loss, creating sustainable, lifelong changes will result in the best outcomes. Most importantly, think about how this restrictive eating plan will fit into your lifestyle, and if you are willing to give up what may be some of your favorite foods. It’s important to make time for yourself to prepare meals at home and get regular exercise. Strive for progress, not perfection.

Burns fat: You can drop a lot of weight — and quickly — on the keto diet.[3] Ketones suppress ghrelin — your hunger hormone — and increase cholecystokinin (CCK), which makes you feel full.[4] Reduced appetite means it’s easier to go for longer periods without eating, which encourages your body to dip into its fat stores for energy. Learn more here about the keto diet and weight loss. 
“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.”
When foods are processed, their potassium levels actually decrease. So, choosing whole or minimally processed foods can improve blood pressure regulation from both a sodium and a potassium perspective. In addition, you’ll usually decrease your intake of saturated fat, added sugars, and overall calories—all of which can help you lose weight, and keep it off for good. 

You’re a diabetic counselor and are talking about being worried about not being able to eat birthday cake? Hell I’ve been on keto since July 2016 and haven’t felt any urge to go back, simply because I feel so much better. Also the diet is really not all that restrictive, you can make desserts using stevia/erythritrol, coconut/almond flour, etc. I had ketogenic pizza the other night and it turned out great. Lots of great resources out there for food options. I’m not diabetic myself, but I used to be prone to hypoglycemia and keto has eliminated the issue since I’m not dependent on glucose. There are a lot of wrong ways to do keto though, and doing the diet correctly has a moderate learning curve.
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.
Many CDEs actually have diabetes…it’s what draws them to choose this career…to help others with diabetes, to share their knowledge. Most already wear an insulin pump and continuous glucose sensors (CGMs) also. When I first became certified on each new pump and CGM, I would wear them (and check my BG 4-6 times per day) for 2-3 weeks, not only to learn the technology really well, but to gain a sense of how my patients must feel having to wear them 24 hours per day. Since, I’ve started a 6 month old baby on a insulin pump and CGM all the way up to a 89 year old…there are no boundaries for people with diabetes!
Fish and seafood come next, eaten about twice a week. Poultry, eggs and dairy in the form of cheese and yogurt are eaten in moderate portions on a daily or weekly basis. For example, one review of research on Mediterranean eating suggests about four eggs a week. At the very top of the pyramid -- meaning you eat them only sparingly -- are red meat and sweets. Preferred beverages include water, as well as red wine, in moderation.
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.’
Financial disclosures: There were no conflicts of interest reported except for Dr Bernstein who has received royalties for books on the management of diabetes (which were used by members of the online social media group surveyed in this study). Dr. Hallberg who holds stock options and receives research support from Virta Health, and consulting fees from Atkins. Dr. Rhodes is the site principal investigator in clinical trials for pediatric type 2 diabetes that are sponsored by Merck and AstraZeneca. Dr. Westman has an ownership interest in companies using low-carbohydrate principles, and he receives royalties for books related to low-carbohydrate diets. Dr. Ludwig has received royalties from books on nutrition and obesity; and Dr. Galati is author of Eating Yourself Sick: How to stop obesity, fatty liver, and diabetes from killing you and your family (2018).
Imagine your body is a home with a fireplace in the middle and the heat required to keep it at a comfortable\livable temp is keeping the fireplace burning at a manageable and constant pace. To do this you have two fuel-types at your disposal: Kerosene and Charcoal. (in this analogy Kerosene is carbohydrates and coal is fat). American diets are high in carbs, which is like throwing a bucket full of kerosene on that fire. Will it keep the house warm? Sure, but it burns down fast so you have to keep throwing bucket after bucket on it to keep it going, consuming tons of kerosene, and you get these huge spikes in heat. It is much harder to control the strength of the flame, and thus much harder to keep the house at a constant, comfortable temp.

Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet (MAD) or the low-glycaemic index treatment (LGIT) diet, because they find the difficulties too great.[41]
You even have root vegetable and a picture of a carrot. Carrots are not part of a keto diet and as far as I have seen never were. They have 2 much sugar content and are discouraged except in very small amounts. Are you sure you tried it? Sorry. Great article in many ways but outdated in others. I don’t think people go into thinking they will “do it forever” How long can I last? I think that is missing the point entirely. So many people are getting their triglycerides down, losing weight reducing stroke possibilities lengthening their very lives. It is just not fair to not at least point out a few of these things as much as the risks you made sure to point out. albeit they are very important. How about the risks of not doing something? How about the list of people that found this and turned their lives around. Also, I know several people who have been doing keto for years.
My husband and I have been doing this diet for a while now. And let me tell you it works. He has lost weight and his blood pressure has gone down!! It isn't a hard diet at all, the first 2 weeks you learn to live without carbs , but that isn't to bad. The 2nd phase you start adding some carbs back along with other foods. It's all about making the right choices.
Also, as I believe is mentioned, this diet has been around for along time and was the only way to treat diabetes. And some people did die. However, people still end up dead from t2d even after all the diet advice from educators and with all that pharmacy has to offer. An industry which gains nothing if people just choose to eat less. But has lots to gain if we just keep taking the tablets.
Financial disclosures: There were no conflicts of interest reported except for Dr Bernstein who has received royalties for books on the management of diabetes (which were used by members of the online social media group surveyed in this study). Dr. Hallberg who holds stock options and receives research support from Virta Health, and consulting fees from Atkins. Dr. Rhodes is the site principal investigator in clinical trials for pediatric type 2 diabetes that are sponsored by Merck and AstraZeneca. Dr. Westman has an ownership interest in companies using low-carbohydrate principles, and he receives royalties for books related to low-carbohydrate diets. Dr. Ludwig has received royalties from books on nutrition and obesity; and Dr. Galati is author of Eating Yourself Sick: How to stop obesity, fatty liver, and diabetes from killing you and your family (2018).
^ Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–63. doi:10.1542/peds.102.6.1358. PMID 9832569. https://web.archive.org/web/20040629224858/http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM Lay summary]—JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.
What is your opinion on the conflicting opinions about whether or not wine is healthy or harmful? It seems there is a daily article touting research that proclaims wine is health alternating with another article about research that indicates that even moderate intake of wine is associated with cancer or dementia. I’m trying to understand all of this conflicting data with the reality/evidence of Mediterranean cultures that include daily intake of wine. Is it the amount drunk that is key?
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.
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.
Normal dietary fat contains mostly long-chain triglycerides (LCT). Medium-chain triglycerides are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate,[3] leading to more food choices and larger portion sizes.[4] The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil.[15] Consuming that quantity of MCT oil caused abdominal cramps, diarrhoea and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant.[9] The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.[3]
What the diet advocate says: ‘We are committed to always being the best weight management program on the planet, but now we’re putting our decades of knowledge and expertise in behavioral science to work for an even greater mission,’ says Mindy Grossman, President and Chief Executive Officer, WW. ‘We are becoming the world’s partner in wellness. No matter what your goal is – to lose weight, eat healthier, move more, develop a positive mind-set, or all of the above – we will deliver science-based solutions that fit into people’s lives.’
Meanwhile, more than 70 trials have examined the health effects of a low-carb diet. They attest to the benefits64 associated with ketosis and low-carb diets, including a reduction in body weight and body mass index, improved cardiovascular risk factors including blood pressure, and the reversal of Type 2 diabetes. It is virtually impossible to imagine that a diet with so many health improvements in the ‘near term’ (2 years) could ultimately shorten life—and the study authors offer no possible mechanism to explain how this might happen.
But again, when it comes to salt, there's a blood pressure-weight link that can't go ignored. A diet rich in sodium may lead to the development of obesity, according to one study, and salty foods are more likely to promote overeating, which obviously also leads to weight gain, per another study. And by now, it's more than evident that excess fat and sugar intake can contribute to caloric surpluses, blood sugar and insulin spikes, inflammation, and, yes, more weight gain, she says.

I believe the keto diet caused the TIAs, as did the RD that I worked with at the time. The choking (dysphagia) was not an issue until the second stroke .The TIA caused the aspiration. Yes, I believe it was the diet. If it works for you; Great! But this should never ever been tried on a man that was already sick, CBGs out of control and elderly to boot. The wife said she got it from a website such as yours. There should be warnings posted that this is diet is not for everyone and for goodness sake talk to a professional before jumping on the trend bandwagon. It can cause (and did) irreparable harm.
The Mediterranean diet wasn’t built as a weight loss plan — in fact, because it wasn’t developed at all, but is a style of eating of a region of people that evolved naturally over centuries, there’s no official way to follow it. But it’s popular because it’s a well-rounded approach to eating that isn’t restrictive. Two of the five Blue Zones — areas where people live longer and have lower rates of disease — are located in Mediterranean cities (Ikaria, Greece and Sardinia, Italy). (2) These places are known for having some of the lowest rates of heart disease and cancer worldwide. (3)

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.
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.
Beans can help boost feelings of fullness and manage blood sugar levels, making them an excellent ally in your weight loss battle. In fact, a recent study published in The American Journal of Clinical Nutrition found eating one serving a day of beans, peas, chickpeas or lentils could contribute to modest weight loss. And if you need another reason to bulk up on beans, remember that the fiber and protein-rich legumes are other excellent sources of genistein—the same compound found in peanuts and lentils that aids weight loss.
The low-carb diet induces ''nutritional ketosis," Dr. Saslow tells EndocrineWeb, which is not the same as ketoacidosis. Ketones are a chemical your body produces when you burn stored fat; if you are on a low-carb diet you may be ''in ketosis.'' Ketoacidosis is different; it is a life-threatening condition in which levels of ketones and blood sugar are dangerously high, which may occur in people who have poorly controlled diabetes.
“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.’”
The food options available on the DASH diet closely mirror the eating plan recommended in the US Department of Agriculture’s MyPlate, with a focus on whole foods, such as fruit and veggies; fat-free or low-fat dairy; whole grains; and lean meats, like fish and poultry. (3) Meanwhile, the plan requires cutting back on, or preferably eliminating, processed foods, like sugary drinks and packaged snacks, and limiting red meat, which in excess has been linked to poorer heart health and heart failure, according to a study published in the journal Nutrition, Metabolism and Cardiovascular Diseases. (4)
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. 
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.
For me, I chose to become a CDE because I had worked as a Registered Nurse first on a medical unit, then in a Medical ICU. These are the units where most of the people with diabetes are, so I had seen every horrific complication that diabetes can cause. When I had a chance to become a Diabetes Educator…to actually help PREVENT some of those horrible complications…I jumped at the chance!
It is possible to combine the results of several small studies to produce evidence that is stronger than that available from each study alone—a statistical method known as meta-analysis. One of four such analyses, conducted in 2006, looked at 19 studies on a total of 1,084 patients.[22] It concluded that a third achieved an excellent reduction in seizure frequency and half the patients achieved a good reduction.[3]
Trim Portions. If you did nothing else but reduce your portions by 10%-20%, you would lose weight. Most of the portions served both in restaurants and at home are bigger than you need. Pull out the measuring cups to get a handle on your usual portion sizes, and work on paring them down. Get instant portion control by using small bowls, plates, and cups, says Brian Wansink, PhD, author of Mindless Eating. You won't feel deprived because the food will look plentiful on dainty dishware.
That's certainly the case with the ketogenic diet—a very low-carb meal plan—based on the findings of two recently published studies.1,2  Dr. Saslow and her team report that the individuals with type 2 diabetes who followed the keto diet lost significantly more weight than those on the low-fat diet espoused by the American Diabetic Association.1 These dieters also were able to get their hemoglobin A1c (HbA1c) below 6.5%, suggesting that some may have reversed their type 2 diabetes.1
Around this time, Bernarr Macfadden, an American exponent of physical culture, popularised the use of fasting to restore health. His disciple, the osteopathic physician Dr. Hugh William Conklin of Battle Creek, Michigan, began to treat his epilepsy patients by recommending fasting. Conklin conjectured that epileptic seizures were caused when a toxin, secreted from the Peyer's patches in the intestines, was discharged into the bloodstream. He recommended a fast lasting 18 to 25 days to allow this toxin to dissipate. Conklin probably treated hundreds of epilepsy patients with his "water diet" and boasted of a 90% cure rate in children, falling to 50% in adults. Later analysis of Conklin's case records showed 20% of his patients achieved freedom from seizures and 50% had some improvement.[10]
Cons: In our experience, capping your calories low will probably mean a lot of internal strife and stress. Plus, we’re big fans of enjoying food instead of fearing it, and 800 calories doesn’t leave much room for satisfied taste buds. Lastly, if you’re currently eating double to triple this amount of food, dropping to a daily caloric intake this low can tank your metabolism and actually slow weight loss more than switching to one of these other diets might. (Curious? Here’s why starving yourself won’t help you lose weight.)
Bingo!! It’s all about the $. The info graphic at the very beginning is labeled Keto-Paleo. And is misleading. Contrary to popular belief the Paleo diet is plant based. It restricts carbohydrate and dairy consumption based on foods that cause an inflammatory response in the body. Keto restricts foods that cause a blood sugar spike two very different purposes. American nutrition is very obviously broken and any recommendation tied to a money making association should be taken with a grain of salt because you can bet there are $$ strings attached. Usually big Pharma funding.
High blood sugar levels coupled with high blood ketones, on the other hand, will mean that you have a pathologically low level of insulin – something non-diabetics do not suffer from. This can lead to ketoacidosis – a potentially life-threatening condition. If this happens, you’ll need to inject more insulin; if you’re at all unsure of what to do, contact a medical professional. Coveting really high blood ketones for weight control is not worth the risk for type 1 diabetics.
It's important to note that the drop-out rate was substantial and reports of symptomatic hypoglycemia 1-5 episodes) were experienced by 69% of those in the study. The mean carbohydrate intake was 35 grams (+/- 15) daily. Based on self-reported results, the change in HbA1c was -1.45% (+/- 1.04, P < 0.001) with an average HbA1c of 7.2%  associated with greater hypoglycemia; yet, these results are comparable to other study findings. The average blood glucose levels were 104 mg/dL (+/- 16). 2  Final lipid profiles were mixed. The results were similar for adults and children.
Very low levels of thyroid hormone usually indicate an autoimmune reaction to the thyroid gland itself. This means you’ll have to take thyroid hormone supplements orally, usually the stable form T4 (Levaxin), which your doctor can prescribe for you. Your body will transform this into the active T3 hormone when necessary. The supplement dose should be adjusted so that you reach normal hormone levels (TSH, T3, T4) and sufficiently alleviate symptoms – though a few people feel best when keeping TSH slightly below normal.
Although you'll be cutting way back on carbohydrates and sugar, some fruits are still okay to eat on the keto diet (though you'll still want to be mindful about quantity in order to remain in ketosis). The fruits that make the cut contain far fewer carbs than their off-limits cousins such as apples, pears, bananas, pineapples, papayas, grapes, and fruit juices in general.
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