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.
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.
I think what bothered me most about the article was the way in which the writer has put her own fears about living without cake onto the shoulders of any diabetic she might treat. In the same way an epileptic might choose a life without cake in order to remain seizure free I choose a life without cake to remain “undiabetic”. I must admit that when I was researching this diet I did worry that I would not have the stamina, but the thought of going blind is a useful motivator.
The Mediterranean diet is most famous for its benefit to heart health, decreasing the risk of heart disease by, in part, lowering levels of “bad” LDL cholesterol, and reducing mortality from cardiovascular conditions. It’s also been credited with a lower likelihood of certain cancers, like breast cancer, as well as conditions like Parkinson’s disease and Alzheimer’s disease. (1)
My principal hope in this article is to provide journalists with a resource to do what basic journalism demands, namely to ensure that stories are scientifically balanced and accurate. At the end of this post I provide contacts for some of the credentialed experts who helped me compile this research. Reporters, please seek out these or other low-carb diet experts so you can provide accurate, up-to-date information for your readers.
The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter. Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.
What a great post. I thought i would add about the selection of food you eat on keto and that everyone is different. Some food gives you energy and some doesnt, this varies person to person. I started and quit keto 3 times before i managed to find my balance. The first few times it made be poorly, from the shock of diet change. However, you can wean yourself into the diet which i did the last time when i had the most success.
However, the meta-analysis was riddled with confounding variables — one of which being their lackadaisical definition of a low-carb diet. The researchers identified a low-carb diet as a diet where less than 45% of its calories come from carbs. With such a lax criterion for low-carb, it is difficult to tell if a true low-carb diet (i.e., fewer than 26% of calories coming from carbs) is genuinely the best dietary option for type 2 diabetics.
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. 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 and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet. 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. 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).
Keep a food diary. In it, record your current daily eating habits. Write down what you eat for every meal of the day, and take note if you skip a meal. If you regularly skip breakfast, jot this down as well. Also write down any snacks you eat, even if you do this mindlessly - say, while watching TV. This diary will allow you to see where you stand right now in terms of eating practices and where you can start to make changes.
“A little forethought can go a long way,” says Monica Auslander Moreno, MS, RD, LDN, consultant at RSP Nutrition. “In my practice I help clients stay on track with weekly meal prep planning guides or prep survival kits. If you fail to plan, you plan to fail,” she explains. By planning your meals in advance, you're less likely to give into temptation or consume extra calories from hidden oils, sugar, and sodium in many take-out dishes.
There are numerous benefits that come with being on keto: from weight loss and increased energy levels to therapeutic medical applications. Most anyone can safely benefit from eating a low-carb, high-fat diet. Below, you’ll find a short list of the benefits you can receive from a ketogenic diet. For a more comprehensive list, you can also read our in-depth article here >
When compared to the calorie-restrict diet, the subjects who underwent the ketogenic diet experienced a reduction three times greater in hemoglobin A1C (1.5% vs. 0.5%).  In addition to observing greater improvements in diabetes-related markers, researchers observed a greater reduction in medication usage in subjects that underwent the ketogenic diet treatment. Thus, due to their overall findings, the researchers stated that “Lifestyle modification using low carbohydrate interventions is effective for improving and reversing type 2 diabetes.” 
Meal planning also causes you to look at your calendar and consider everyones schedule. Grocery shopping can again become part of the family routine with everyone contributing to the meal. You’ll also notice a change in your weekly food budget. Susan pointed out that she had, “Given a presentation on the cost of buying food and cooking meals at home saved $1,200 a year versus eating out. Eating out on average costs people about $2,000 a year. Yes, there are some up front costs when buying the spices or equipment you may need but the second time you go to use them, you are saving instead of spending.”
A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital and followed-up by a report published in 2001. As with most studies of the ketogenic diet, there was no control group (patients who did not receive the treatment). The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction and 3% were seizure-free.[Note 7] At twelve months, 55% were still on the diet, 23% had a good response, 20% had an excellent response and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three and four years was 39%, 20% and 12% respectively. During this period the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free but had had an excellent response.
“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.”
If you have health reasons that make you want to try it and eating bacon, eggs and steak salads every day sounds amazing, maybe you could swing it. If nothing makes you happier than a fresh piece of sourdough, or if beans are one of the protein sources you rely on, there’s no point in trying a diet that’s not going to work. (And, by the way, sourdough toast with mashed avocado for breakfast and black bean soup for lunch are really delicious and healthy.)
"Even though it's called the Mediterranean diet, it's not really a diet," said Atlanta registered dietitian Rahaf Al Bochi, a spokeswoman for the Academy of Nutrition and Dietetics. "It doesn't tell you what to eat and not eat. It's a lifestyle that encourages consuming all food groups but gives more weight to those which have the most health benefits."
Thank you SO much for this! My husband approached me about the Mediterranean diet being good for depression and suggested I give it a try. But I already knew this was not the best term to describe what I needed, even before reading your article on the subject. However, I did have an idea of what they meant and I have struggled to find recipes that fit the bill. Too many well-meaning people have made it more “healthful” by cutting back on the fat. ANYWAY . . . This little meal plan is going to be immensely helpful to me and I am poking all around the site and your social media. Thank you for sharing!
There isn't "a" Mediterranean diet. Greeks eat differently from Italians, who eat differently from the French and Spanish. But they share many of the same principles. Working with the Harvard School of Public Health, Oldways, a nonprofit food think tank in Boston, developed a consumer-friendly Mediterranean diet pyramid that offers guidelines on how to fill your plate – and maybe wineglass – the Mediterranean way.
Finding keto-friendly foods can be difficult at social gatherings — so consider bringing your own snacks. “If I know the restaurant where I’m meeting my family or friends, I usually look through the menu in advance and see if there’s something I can eat,” says Lele. “Salads are generally safe, with ranch or another low-carb dressing and a non-marinated protein. There are a lot of hidden carbs in restaurant food!”
i began eating the Mediterranean “diet” last January. Actually began with the Daniel plan in getting ready for my sons wedding in June! I was able to successfully lose quite a bit of weight and feel wonderful at the same time! It is now the plan i follow most of the time. I still love a good hamburger and fries; but now for the most part eat a Mediterranean style every day! I am grateful that i happen to love the Mediterranean flavors and never feel hungry or deprived! I love the recipes you post and have made many of them! Do you have a cookbook or are your considering putting all your fabulous recipes together in one soon? Thank you for sharing your delicious and healthy recipes!
We’ve said it before and we’ll say it again: fat is your friend! To be more specific, healthy fats will be your weight loss friends. Consider adding extra virgin olive oil to your diet and you might see the scale start to tip in your favor. One Journal of Women’s Health study discovered that an EVOO-enriched diet helped participants lose more weight than those on a low-fat diet. Like peanuts and avocados, extra virgin olive oil’s belly-blasting abilities are thought to be a result of the monounsaturated fats it contains.
Cyclical keto diet: The Bulletproof Diet falls into this category. You eat high fat, low carb (less than 50 grams of net carbs a day) five to six days of the week. On day seven, you up your carb intake to roughly 150 grams, during what’s called a carb refeed day. Carb cycling this way helps you avoid the negative effects some people experience when they restrict carbs long term, like thyroid issues, fatigue and dry eyes. Learn more here about how carb cycling works.
Some people on a keto or low carb diet choose to count total carbs instead of net carbs. This makes it more difficult to fit in more leafy greens and low carb vegetables (which are filled with fiber), so you should only try that if you don’t get results with a net carb method. And, start with reducing sugar alcohols and low carb treats before deciding to do a “total carbs” method.
From intermittent fasting to the keto diet to teatoxes, there's a plethora of diet advice out there. Maybe the keto diet worked wonders for your co-worker, but it’s just not conducive to your nutritional needs. Or not eating after 7 p.m. helped your sister lose 20 pounds, but you like doing evening workouts. The truth is losing weight is hard—and it takes patience—so if it's too good to be true, then it probably is. “Adopting healthy habits is not easy, but most things in life that are worthwhile take work,” explains Bonnie Taub-Dix, RDN and author of Read it Before You Eat It - Taking You from Label to Table. But losing weight doesn't need to be complicated. Following these simple nutritionist-backed tips will help point you in the right direction and reach your goals.
After seeing thousands of patients now for years and from personal experience, I still believe it comes down to staying away from processed foods and cooking at home whenever possible. Eating a variety of fresh fruits, vegetables, proteins, and fiber. Also, cutting out any sugary liquid calories; staying away from sodas, juices and the infamous sweet tea! Keeping stress levels under control and incorporating exercise into your routine will also be key to breaking through challenging times when you are having trouble with continued weight loss.
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.
Mastering Diabetes: Studies conducted in tens of thousands of people over 5+ years indicate that low-carbohydrate diets increase your risk for cardiovascular disease, hemorrhagic stroke, hypertension, atherosclerosis, diabetes mortality, obesity, cancer, and all-cause mortality (premature death). No matter how you slice it, low-carbohydrate diets trick patients and doctors into believing that ketosis is an excellent long-term dietary strategy, when in reality the consequences can be disastrous.
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.
You'll find lots of free Mediterranean diet resources on the Oldways website, including an easy-to-understand food pyramid; a printable grocery list; gender- and age-specific tips on making the Mediterranean switch; a quick-read "starter" brochure; a recipe newsletter; and even a glossary defining Mediterranean staples, from bruschetta to tapenade.
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
It reduces risk of disease. A growing number of studies suggest that people who follow a Mediterranean diet are less likely to die of heart disease than people who follow a typical American diet. (1) What’s more, evidence is emerging that shows people who eat this way have a lower risk of colon cancer, prostate cancer, and some head and neck cancers, according to studies published in September 2016 in the British Journal of Cancer and in February 2018 in the Journal of Urology. (27,28,29)
What if we told you that you could make 20 percent of your belly disappear this year—poof, just gone? Penn State University researchers compared those who consumed avocado oil with those who consumed a flax-safflower oil blend. Those on the avocado oil diet—just three tablespoons daily did the trick—lost nearly 2 percent of their belly fat in just one month. For more ways to enjoy big, bold flavors, burn flab with these 8 Fatty Foods That Make You Skinny.
Add mint to your usual oven-roasted chicken, and it becomes a whole new meal with a Mediterranean diet twist. Plus, it has perks: Mint has been known to alleviate digestion issues. Olives add flavor for very few calories (five olives only have 26 calories), while figs add a natural sweetness. This chicken dish by Russell Bry, concept chef of Yalla Mediterranean in California, just might become your new go-to.
“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.
From baseline to week 16, the mean body weight decreased significantly from 131.4 ± 18.3 kg to 122.7 ± 18.9 kg, BMI decreased from 42.2 ± 5.8 kg/m2 to 39.4 ± 6.0 kg/m2, and waist circumference from 130.0 ± 10.5 cm to 123.3 ± 11.3 cm (Table (Table3).3). The percent change in body weight was -6.6%. The mean percent body fat decreased from 40.4 ± 5.8% to 37.0 ± 6.0%. Systolic and diastolic blood pressures did not change significantly over the 16 weeks. The mean heart rate decreased from 81.2 ± 12.9 beats per minute to 74.6 ± 14.0 beats per minute (p = 0.01).
As far as weight loss is concerned, I have heard great things from many who have switched to eating the Mediterranean way. Some were able to see results in just a few weeks…feeling better and losing a moderate amount of weight. From my personal experience, the only time I wasn’t eating the Mediterranean way was during my early years in college. I attended college in Michigan, and naturally, I ate whatever was available in the school cafeteria. Freshmen year, I gained nearly 30 lb. But lost it all without much effort in 2 months, when I returned home that summer and started to eat Mediterranean again. It’s important to say that the Mediterranean lifestyle is really a way of living, and one we commit to longer term, not necessarily a quick diet for the sake of losing weight. I always mention too that I have no medical or professional background to lend in the area of weight loss. If that is priority, a registered dietitian or someone with that kind of experience would be of help.
Well, I am going to give this another try. I have great difficulty in eating greens , or drinking them, also I am not fond of fats, years and years of low fat diets have totally screwed my metabolism,and taste buds. I will read this page every day to keep my mind focused. Start tomorrow when I get up …… I work nights which can cause me problems as well. When I tried this diet before, I got terrible cramp, now I realise I wasn’t drinking enough water. Anyway.here goes.
The keto diet has been shown to help people lose weight in the short term; however, the long-term benefits of the diet aren't as clear, according to the Mayo Clinic. The diet is named for ketosis, which is the condition the body goes into when following the plan. In ketosis, the body uses ketone bodies, or water-soluble molecules produced by the liver and the breakdown of fatty tissue for cellular energy as opposed to sugars from ingested carbohydrates. And in some people, this results in weight-loss.
It’s easy to stick with. A diet only works if it’s doable. That means everyone in your family can eat it and you can eat in this style no matter where you go (to a restaurant for dinner, to a family event). With its flavors and variety of foods that don’t cut out any food group, this is one such eating plan. "It is an appealing diet that one can stay with for a lifetime,” Dr. Cohen says.
A 2012 study also showed that people on a low-carb diet burned 300 more calories a day – while resting! According to one of the Harvard professors behind the study this advantage “would equal the number of calories typically burned in an hour of moderate-intensity physical activity”. Imagine that: an entire bonus hour of exercise every day, without actually exercising. A later, even larger and more carefully conducted study confirmed the effect, with different groups of people on low-carb diets burning an average of between 200 and almost 500 extra calories per day.
What the diet advocate says: The food baby of the US reality couple Heather and Terry Dubrow (she stars in the Real Housewives of Orange County; he’s a plastic surgeon starring in a show called Botched). ‘As opposed to the keto diet that aims to get you to a ketogenic state of using fat as fuel, which isn’t healthy or sustainable in my opinion, interval eating helps you go into a fat-burning state that leads to increased energy and cell renewal - a process called autophagy, the toxin-eating phase,’ says Terry.
The NY Times Best Sellers, The DASH Diet Action Plan and The DASH Diet Weight Loss Solution, provide real life solutions to make it easy for people to follow the DASH diet. They each have 28 days of meal plans, recipes, guidance for weight loss, how to eat at restaurants, fast food places, etc. and still stay on track. It shows you how to stock up your kitchen for the DASH diet, and how to read food labels to make good choices. And, of course, the meal plans and recipes are all low sodium/low salt. The books show you how to add exercise and other lifestyle changes to help lower blood pressure. The books help you design your own personal "DASH Diet Action Plan" and your own "DASH Diet Weight Loss Solution."
That’s why the Bulletproof Diet uses cyclical nutritional ketosis, and why on days when I eat carbohydrates, I always have Brain Octane Oil so my cells have a steady supply of ketones. This builds metabolic flexibility: you can eat fat and carbs and your body will use them both, which is the goal. You want to be resilient and full of energy no matter what, and that means you want cells strong enough to burn whatever you give them.
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).
In 3 months, I have lost 23 pounds, gone down 5 points in my body fat percentage, and lost 4.5 inches from my waist...after struggling with my weight for decades. (I received a copy of the of the plan guidelines and sample menus in September through the author's Facebook group.) In addition to the outer changes, my cholesterol level dropped to 121, with a commensurate reduction in triglycerides and LDLs.
You still have to cap alcohol. The hallmark of a Mediterranean diet is that drinking red wine socially is thought to be one reason why the diet is so healthy. But women should still stick to one glass, and men two glasses. If you have a history of breast cancer in the family, know that any alcohol consumption raises that risk. (31) In that case, talk to your doctor to find out what’s right for you.
The more doctors test it, the more they find that eating Mediterranean is the absolute best way to lose weight. Based on the cooking and eating styles of Italy, France, Greece, Spain, and other Mediterranean countries, the plan features olive oil, fruits and vegetables, nuts, legumes, fish and poultry, whole grains and, yes, wine! It's high in heart-healthy fats and, unlike other diets, doesn't forbid any food group. "It's hard to stay on extreme diets," says Harvard nutrition expert Walter Willett, MD, PhD, whose book Eat, Drink, and Be Healthy popularized the approach in the United States. "This diet has lots of variety and wonderful flavors so people stick with it."
The primary outcome was the change from baseline to week 16 in hemoglobin A1c. Changes in all variables were analyzed by the paired t-test or Wilcoxon signed-ranks test, as appropriate. Linear regression analysis was used to examine predictors of change in hemoglobin A1c. A p value of 0.05 or less was considered statistically significant. Statistical analysis was performed using SAS version 8.02 (SAS Institute, Cary, NC).
Incidentally , there’s a very informative article on the bbc website about one of the last remaining hunter/gather societies left in the world, living in Tanzania. They have amazing gut health and no t2d. Would you like to guess at the type of diet they follow? This would be the caveman diet that the writer mentions, and yes these people might not live as long as us but the cause of death is never a lack of motivation to stay on a keto diet.
After 32 weeks, those in the keto diet group lowered their HbA1c more than those in the plate group with more than 50% achieving a reduction to less than 6.5%, basically reversing their diabetes. None in the plate group did this well. As for weight loss, those in the keto low-carb group lost on average of 28 pounds, while those in the plate group lost an average of 6.6 pounds.1
Conklin's fasting therapy was adopted by neurologists in mainstream practice. In 1916, a Dr McMurray wrote to the New York Medical Journal claiming to have successfully treated epilepsy patients with a fast, followed by a starch- and sugar-free diet, since 1912. In 1921, prominent endocrinologist Henry Rawle Geyelin reported his experiences to the American Medical Association convention. He had seen Conklin's success first-hand and had attempted to reproduce the results in 36 of his own patients. He achieved similar results despite only having studied the patients for a short time. Further studies in the 1920s indicated that seizures generally returned after the fast. Charles P. Howland, the parent of one of Conklin's successful patients and a wealthy New York corporate lawyer, gave his brother John Elias Howland a gift of $5,000 to study "the ketosis of starvation". As professor of paediatrics at Johns Hopkins Hospital, John E. Howland used the money to fund research undertaken by neurologist Stanley Cobb and his assistant William G. Lennox.
The ketogenic diet is a medical nutrition therapy that involves participants from various disciplines. Team members include a registered paediatric dietitian who coordinates the diet programme; a paediatric neurologist who is experienced in offering the ketogenic diet; and a registered nurse who is familiar with childhood epilepsy. Additional help may come from a medical social worker who works with the family and a pharmacist who can advise on the carbohydrate content of medicines. Lastly, the parents and other caregivers must be educated in many aspects of the diet for it to be safely implemented.
Keep up electrolytes. The major electrolytes in our bodies are sodium, potassium and magnesium. Because a low carb diet (especially a keto diet!) reduces the amount of water you store, this can flush out electrolytes and make you feel sick (called “keto flu”). This is temporary, but you can avoid or eliminate it by salting your food liberally, drinking broth (especially bone broth), and eating pickled vegetables. Some people also choose to take supplements for electrolytes, but it’s best to first consult a doctor that understands and supports keto/low carb lifestyles.
Here’s what we do know: The keto diet may be useful in treating symptoms of epilepsy, a seizure disorder. “The use of keto in treating epilepsy has the most evidence,” Angelone says. One study conducted by Johns Hopkins Medicine, for example, followed epileptic patients on the keto diet and found that 36 percent of them had a 50 percent reduction in seizures after three months on the diet, and 16 percent were seizure-free. However, experts aren't entirely sure why the keto diet has this affect, she adds.