The basal metabolic rate per gram of body weight is seven times greater in mice than in humans. Organisms with large mass-specific metabolic rates typically show relatively large deviations from "normal" values because of a weak capacity to maintain homeostasis. Mice, which have a higher mass-specific metabolic rate, have a weak capacity to maintain cellular homeostasis; humans have a lower mass-specific metabolic rate, and a strong capacity to maintain cellular homeostasis. Mice are not small people, and "everyone else did it" is not a sound experimental design rationale.
We really do only want to try and share the knowledge we have through seeing thousands of different patients with complex issues over decades with all of you. Physicians jump at the chance to have a CDE see their patients in their practice or in the hospital because they know our value. They know how thorough we are when assessing their patients and often find issues that may have been overlooked for years. It’s all we do all day, so it’s our specialty…diabetes. We live and breathe it and are very passionate about helping people overcome their hurdles. I do hope sharing some of my personal experience with all of you will help, but I am here if you all have more questions anytime!
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.
U.S. News & World Report ranked the keto diet at the very bottom of their list of the best and worst diets of 2018. A panel of 25 nationally recognized experts, including Registered Dietitians, Professors, and Clinicians, looked at 40 diets and evaluated their nutritional completeness, ability to produce short-term and long-term weight loss, how easy it is to follow, its safety and potential for preventing and managing diabetes and heart disease.  While keto ranked the worst, the DASH diet and Mediterranean diet ranked the best. Keep reading for more info on these diets.
The keto diet is a low-carb, high-fat dietary regimen which has been linked to improvements in insulin sensitivity and higher rates of weight loss — both positive factors in managing type 2 diabetes. Lowering carb intake induces a metabolic state known as ketosis, through which the body produces ketones which burn fat — rather than carbohydrates — for energy.
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.

“A lot of people think the foundation of a paleo diet is high-fat meat, but I suggest that it’s vegetables,” says Hultin. The concept is to eat only foods — including meat, fish, poultry, eggs, fruits, and vegetables — that would have been available to our Paleolithic ancestors. This means grains, dairy, legumes, added sugar, and salt are all no-no’s.
DASH stands for Dietary Approaches to Stop Hypertension. It’s a lifelong approach to eating that’s designed to prevent and treat high blood pressure, also called hypertension. It also falls in line with dietary recommendations to prevent osteoporosis, cancer, heart disease, stroke, and diabetes.  DASH encourages a variety of nutrient-rich foods while reducing the amount of sodium eaten. This eating plan includes plenty of fruits, vegetables, whole grains, low-fat dairy products, fish, poultry, legumes, nuts, and seeds.  Red meat and sweets are eaten in small amounts.

I must tell you when looking at this link they say the American Diabetes Association Guidelines call for 60-75 carbohydrates per meal and that is simply not true. The ADA has recommended since 2013 we use our best clinical judgement in recommending a low carbohydrate diet for people with diabetes, recognizing it needs to be individualized. 60-75 grams is the carbohydrate amount I would give to a very tall, large boned man or perhaps an active teen or young adult. I would never recommend that many carbohydrates for an average size man who was trying to lose weight; he would get 45-60 grams of carbohydrates per meal and 15-30 grams for snacks. A women trying to lose weight would get 30-45 grams of carbohydrates per meal and 15 grams for snacks.
In nature, historically, there were very few ways to store carbs – which were available only for a short time seasonally. The solution to this is that when eating the available fruit in the autumn the sugars switch off the fat burning system and then use insulin to store the sugars as body fat. Carbs signal our body to go into fat storage mode. When the carbs run out then slowly the fat burning more resumes – first of all feeding ketones to the brain and other vital organs and then eventually to the muscles.
These carbohydrate recommendations are not PER DAY, they are per meal. This is the major difference between Ketogenic diets and a consistent, low carbohydrate diet CDEs advocate for. 30-45 carbs per meal is considered a low carb diet. Eating this in the form of a Mediterranean diet is what I recommend and what my article outlined. In a perfect world, we try to have people steer clear of anything artificial or processed when possible. Just eat fresh foods, like our grandparents did, who never had these types of health problems.
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.
You’re transitioning. Your body is equipped to process a high intake of carbs and a lower intake of fat. Your body needs to create enzymes to be able to do this. In the transitional period, the brain may run low on energy which can lead to grogginess, nausea, and headaches. If you’re having a large problem with this, you can choose to reduce carb intake gradually.
In 1921, Rollin Turner Woodyatt reviewed the research on diet and diabetes. He reported that three water-soluble compounds, β-hydroxybutyrate, acetoacetate and acetone (known collectively as ketone bodies), were produced by the liver in otherwise healthy people when they were starved or if they consumed a very low-carbohydrate, high-fat diet.[10] Dr. Russell Morse Wilder, at the Mayo Clinic, built on this research and coined the term ketogenic diet to describe a diet that produced a high level of ketone bodies in the blood (ketonemia) through an excess of fat and lack of carbohydrate. Wilder hoped to obtain the benefits of fasting in a dietary therapy that could be maintained indefinitely. His trial on a few epilepsy patients in 1921 was the first use of the ketogenic diet as a treatment for epilepsy.[10]
Either there are very few participants in the studies, they don’t have an even number of males vs. females, or they don’t last but a few months. One study only looked at 28 people; only 21 completed the study and 20 of these participants were men. On top of this, they were only followed for 16 weeks. Okay, so we see that 20 men can limit their carbohydrates severely for 4 months and lose weight which automatically makes their A1c come down. Great! So, the real question is, how long can these 20 men stay on this diet for the rest of their lives? How long would you like to go without eating any fresh fruit? I’m craving some now, so I’m taking a break to go grab a snack now!
Numerous studies show wide-ranging health benefits of the DASH diet. A consistent body of research has found that DASH lowers blood pressure in people with high blood pressure but also normal blood pressure even without lowering sodium intake. [4] It can produce greater reductions in blood pressure if sodium is restricted to less than 2300 mg a day, and even more so with a 1500 mg sodium restriction. [5, 6] When compared with a standard American diet (e.g., high intake of red and processed meats, beverages sweetened with sugar, sweets, refined grains) DASH has also been found to lower serum uric acid levels in people with hyperuricemia, which places them at risk for a painful inflammatory condition called gout. [7] Because people with gout often also have high blood pressure and other cardiovascular diseases, DASH is optimal in improving all of these conditions.
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.
After about two to seven days of following the keto diet, you go into something called ketosis, or the state your body enters when it doesn't have enough carbs for your cells to use for energy. That's when you start making ketones, or organic compounds that your bod then uses in place of those missing carbs. At this point, your body also starts burning fat for more energy, says Beth Warren, R.D., founder of Beth Warren Nutrition and author of Living A Real Life With Real Food.
Your body uses the carbohydrates you eat for energy, so if we restrict how many carbohydrates we eat, the body has to get its fuel source from fat. A byproduct of this fat burning state are ketones which are produced; this is called nutritional ketosis. You can determine if you are in this fat burning state by purchasing urine ketone testing strips from your local pharmacy.
I’m Dr. Caroline Apovian–the medical nutrition expert for DASH for Health.   I bring over a decade of experience in helping people lose weight to the DASH diet program. I use the successes my patients have had to help the people using this system achieve healthy weight loss. You won’t find any claims here that weight loss is easy and effortless, but the DASH diet makes it simple. When you first log in, you will calculate how many calories you should be eating each day. From there, you will get access to your DASH eating plan. You can track your food intake, exercise and weight all in the DASH for Health system. Also, you can receive real-time progress reports that show you how you are doing.

A majority of the meal planning for the Mediterranean diet consists of fresh fruits and vegetables. A sample days meal menu consists of: a pumpkin-gingerbread smoothie for breakfast, Macaroni with Milk (Macoroni oil-Hali) for lunch, and Trout with Wilted Greens for dinner. Your suggested snacks during the day: Mango-Pear Smoothie, cashews and raisins, low-fat ricotta cheese with peaches, hummus, and seed and nut snack bars.


What the diet advocate says: ‘FODMAPS are either absorbed slowly from the small intestine or not absorbed at all,’ says Dr Gibson, a professor of gastroenterology at Monash University in Melbourne, Australia, and the brains behind the low-FODMAP diet. ‘When the FODMAPs move into the bowel, where they are fermented by bacteria, this produces gas and can also cause water to move into the bowel. This stretches the bowel wall, which stimulates the gut.’
In the study, researchers fed mice (!) a keto diet for three days (!), and then ran a glucose tolerance test. They noticed that while the mice on a keto diet had a lower fasting blood glucose, it got higher after the glucose tolerance test and there were signs of a reduced effect of insulin compared to mice on regular mouse chow. That’s basically it.

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.

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]


A study published in the journal Nutrition & Metabolism discouraged the Atkins diet for anyone with diabetes because the plan doesn’t limit fat, but noted the approach may be a safe way for people without the disease to lose weight effectively. According to a study published in the Journal of the American Medical Association, Dr. Atkins helped women lose weight better than other low-carb diets, such as the Zone diet, the Ornish diet, and the LEARN diet after 12 months.
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The 2-week turbocharge is a great way to kick off the plan: all the claims about resetting your body's expectations proved true for me. In the 3 months I've been on this plan I started a new job; celebrated my anniversary, Halloween, my birthday, & Thanksgiving, and now find myself surrounded by all the Christmas treats...and still find it easier than it's ever been to make conscious choices about what I eat.

The more recent study was conducted online to ascertain if this online approach proved effective in eliciting weight loss.1 Dr. Saslow's team randomly assigned the 12 participants to the Keto diet and lifestyle improvement group and another 13 individuals to the traditional low-fat diet known as the Plate Method,1 supported by the American Diabetes Association. 


Eating low-carb paleo means removing items like rice, pasta, and legumes from your diet completely, but the carbs you eat will be from vegetables like fruit, beets, sweet potatoes, and leafy greens, such as spinach and kale. The diet also cuts out processed food plus foods allowed on other low-carb diets, including milk and cheese, and some people have an easier time sticking with the diet when more carbs are included.
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.
Starting on a ketogenic diet can influence your exercise performance in multiple ways, both positive and negative. During the first 1-2 weeks (the “adaption period,” which I will get back to later), you will most likely see a decrease in energy and athletic performance across the board while your body adjusts to the new diet. This is perfectly normal and should NOT be a cause for concern or make you abandon the diet.
It's generally accepted that the folks in countries bordering the Mediterranean Sea live longer and suffer less than most Americans from cancer and cardiovascular ailments. The not-so-surprising secret is an active lifestyle, weight control, and a diet low in red meat, sugar and saturated fat and high in produce, nuts and other healthful foods. The Mediterranean Diet may offer a host of health benefits, including weight loss, heart and brain health, cancer prevention, and diabetes prevention and control. By following the Mediterranean Diet, you could also keep that weight off while avoiding chronic disease.
Some antidepressant medications can cause weight gain, especially the older tricyclic antidepressants (TCAs) such as Tryptizol, Saroten, and Clomipramine; as well as newer drugs such as Remeron (Mirtazapine). Lithium (for manic-depressive disorder) often causes weight gain. The most common antidepressants known as SSRI’s (for example Citalopram and Sertraline) usually don’t impact weight significantly. More on depression
“A lot of people think the foundation of a paleo diet is high-fat meat, but I suggest that it’s vegetables,” says Hultin. The concept is to eat only foods — including meat, fish, poultry, eggs, fruits, and vegetables — that would have been available to our Paleolithic ancestors. This means grains, dairy, legumes, added sugar, and salt are all no-no’s.
While reading the weekly meal plans I could close my eyes and picture enjoying the tastes of these dishes while soaking in the awesome summer weather on the patio with my girlfriend, with a glass of my favorite California red wine. “The diet also recommends four ounces of red wine in the evening with your meal. Red wine contains flavonoid which helps reduce your risk of developing cardiovascular disease. That’s my favorite part,” shared Susan.
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.
How many times have you heard a doctor specifically name a diet that fights heart disease and helps you lose weight? By name? We’re always told to eat healthy, maybe you are given a list of foods to add or avoid but from that point it’s on you to bring the meal plan together. Not with the Mediterranean diet. “This diet is for anyone but specifically for those with high blood pressure,” says Susan. “This is a low sodium, low fat, low cholesterol diet. It’s also ideal for those that are at risk for developing cardiovascular disease. It’s also great for weight loss or management, so if you are looking to shed a few pounds this is a great diet to embrace.”

Reynolds, AN. "Comment on 'An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals with Type 2 Diabetes: A Randomized Controlled Trial." Journal of Medical Internet Research. 2018; 20(5):e180, May 2018. Available at: http://www.jmir.org/2018/5/e180/  Accessed May 4, 2018.
Control Your Environments. Another simple strategy to help cut calories is to control your environment -- everything from stocking your kitchen with lots of healthy options to choosing the right restaurants. That means avoiding the temptation by staying away from all-you-can-eat restaurants. And when it comes to parties, "eat a healthy snack before so you won't be starving, and be selective when you fill your plate at the buffet," suggests Ward. Before going back for more food, wait at least 15 minutes and have a big glass of water.

I think that the experts don’t want to admit that they have been wrong all this time, They all screamed low fat/high carb which is a miserable, unsatisfying way to eat. Who wants to eat a potato with plain yogurt? Gross! She mentions that you are missing out on vital nutrients, but where is the mention that you are giving up things your body needs when you limit fats too? Keto is the only way to eat where you feel satisfied. I would eat cereal and be starving an hour later. How is that helpful? I can eat bacon and eggs (no toast), and be perfectly content for hours. It takes more food preparation, but I truly believe now that bread (whole grain or not) is the enemy of man.


I would love to join a study! Could you recommend where to go to find one? I have done 30 or less total carbs a day for almost 2 years and feel great. I have NEVER EVEN ONCE gone over 40 total so I do follow it and I do not cheat on high carb foods, although I do occasionally over-eat on low carb foods resulting in a bit over 30 maybe 1 -2 times a month. I do feel that time will provide more support and think that the medical community should educate on this as another alternative. It isn’t for everyone because it is a bit more problematic if a person does fall of the straight and narrow too often but it can be done!
Bulk buy and cook. If you’re someone who doesn’t like to spend a lot of time in the kitchen, this is the best of both worlds. Buying your food at bulk (specifically from wholesalers) can reduce the cost per pound tremendously. Plus, you can make ahead food (bulk cook chicken thighs for pre-made meat, or cook entire meals) that are used as leftovers, so you spend less time cooking.
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.

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
If you’ve decided to move forward in trying the keto diet, you will want to stick to the parameters of the eating plan. Roughly 60 to 80 percent of your calories will come from fats. That means you’ll eat meats, fats, and oils, and a very limited amount of nonstarchy vegetables, she says. (This is different from a traditional low-carb diet, as even fewer carbs are allowed on the keto diet.)
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