I think the larger question is why we are seeing such a sudden rash of anti-keto stories. So many of them quote no experts sources and do not provide citations for their claims. Skeptics with little acquaintance with the diet are quoted exclusively instead. From a journalistic perspective, this lack of balance of viewpoints and the failure to back up claims with evidence falls below basic reporting standards. Offenders on this list include even the Harvard School of Public Health, which recently published more than one  unsourced, one-sided article on the keto diet (This is in addition to the Lancet Public Health article cited above, by Harvard researchers, which suggests that a low-carb diet kills you). These stories could reflect lazy reporting or they could very well be scare tactics to steer people away from the keto diet.  Why would reporters or scientists at Harvard be doing such a thing? That’s material for another post. Stay tuned.
Throughout this article, we looked at the data and the principles behind how low-carb dieting affect patients with diabetes, but we never addressed what you can do about it directly. If you’d like to learn about practical strategies that may help you reverse insulin resistance and improve your blood sugar and HbA1C levels, I recommend reading these articles:

Body Fat Reduction. According to the current research literature, both visceral and subcutaneous fat play a role in the development of type 2 diabetes. [22] To keep our fat cells from fighting against us, we must adopt a healthier lifestyle that prevents us from being in a calorie surplus and gaining weight. The keto diet is one lifestyle change that has been proven time and time again to help us lose fat and improve metabolic health.  [24]


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%). [9] 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.” [9]


Insulin is released in the blood and used to control blood sugar levels including signaling the liver to stop producing sugar. If this system is impaired and the body does not use insulin properly, which is called insulin resistance, individuals are likely to develop high blood sugar levels. In this study the researchers showed that for ketogenic diets this process for controlling blood sugar levels does not work properly and there was insulin resistance in the liver. When the liver is unable to respond to normal levels of insulin to control blood sugar levels this may lead to an increased risk of Type 2 diabetes.

The Mediterranean Diet (or Med Diet) reflects a way of eating that is traditional in the countries that surround the Mediterranean, but you don’t need to travel any further than your local supermarket to discover its delicious flavors and fresh foods. It’s easy to bring the remarkable health benefits and affordable Mediterranean style of eating to your kitchen cupboards, your refrigerator, your countertops, your stovetop, your oven, and your table every day. Embracing the Med Diet is all about making some simple but profound changes in the way you eat today, tomorrow, and for the rest of your life.
The researchers agree that the diet itself isn’t inherently dangerous. But, cautions Weiss, “If you have any medical condition, if you take any medicine at all – there are lots of things that change how medicines work in our bodies, and nutrition is definitely one of them. If you’re making a real change in your nutrition, you really should talk to your doctor.”
Be choosy about carbs. You can decide which ones you eat, and how much. Look for those that are low on the glycemic index (for instance, asparagus is lower on the glycemic index than a potato) or lower in carbs per serving than others. Whole grains are better choices than processed items, because processing removes key nutrients such as fiber, iron, and B vitamins. They may be added back, such as in “enriched” bread.

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)

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.
It appears that a ketogenic diet is generally safe when implemented correctly. One must be careful to obtain all the necessary nutrients by eating a variety of foods, such as non-starchy vegetables, seeds, and nuts, and also consume adequate protein and essential fatty acids. Provided that the need for vitamins, minerals, amino acids and fatty acids is met, there is no reason to suspect that the ketogenic diet is unsafe.
A relatively new offering, the Nutritarian diet is based on maximizing the amount of healthy vitamins, minerals, and trace nutrients in your food, balancing your hormones, and avoiding toxins. The plan—created by Joel Fuhrman, M.D., author of The End of Dieting—is nutrient-dense, plant-rich, and includes anti-cancer superfoods to help you not just lose weight but live a long, disease-free life. (P.S. Follow these guidelines to make sure you're absorbing all the nutrients from your food.)

A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).
More good news: Snacks are totally allowed (and I'm not just talking about carrot sticks). There are plenty of packaged options out there designed for keto fans. FATBAR is one of them. These snack bars have 200 calories, 16 grams of fat, and four grams of net carbs. They're also plant-based and are made with almond or cashew butter, cocoa butter, coconut, pea protein, sunflower seeds, and chia seeds.

One study from 2005 followed 22 people with Type 1 Diabetes for 12 months. The difference here however is they consumed 70-90 grams of carbohydrates per day versus the restrictive less than 20 grams per day on the Ketogenic Diet. Remember my motto? Moderation is the key! The results were positive; less hypoglycemia, insulin requirements were reduced and their A1c dropped from 7.5% to 6.4%.
What about fruits and vegetables? All fruits are rich in carbs, but you can have certain fruits (usually berries) in small portions. Vegetables (also rich in carbs) are restricted to leafy greens (such as kale, Swiss chard, spinach), cauliflower, broccoli, Brussels sprouts, asparagus, bell peppers, onions, garlic, mushrooms, cucumber, celery, and summer squashes. A cup of chopped broccoli has about six carbs.
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]
One of the most important ingredients is abundant physical activity. The base of the Mediterranean diet is an abundance of fresh fruits, vegetables, olive oil, beans, nuts, legumes, and whole grains. Next, add in fish and seafood at least twice a week, followed by some poultry, eggs, and dairy, especially fermented dairy like yogurt and cheese. The very top of the pyramid is reserved for a small amount of red meat and sugary treats (in small portions and for special occasions).
I can’t tell you how often through the years I have been asked the question, “If I lose 20 pounds, will I no longer have diabetes?” Let me answer this very clearly, there is currently no cure for diabetes. Once you have been diagnosed, you have it for life. Every day, our most brilliant researchers are busy searching for a cure though. There is good news however; you can manage your diabetes, get it under control, prevent all the complications of diabetes and live a normal, healthy life.

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.
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.

Full disclosure: I have followed a low-carb diet for nearly a decade and find no problem adhering to it. I’ve lost weight and all my cardiovascular biomarkers have improved. Moreover, I’ve studied the science and history behind low-carbohydrate diets, so beyond my personal experience, I bring an evidence-based perspective. (Previously, for 25+ years, I adhered faithfully to a “mostly plants” regimen of fruits, veggies, and whole grains, including my own homemade 7-grain bread, while exercising religiously. Yet during that time my blood lipids were unhealthy, and I never could shake an extra 10-20 pounds.)
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.
Your body needs a certain amount of essential vitamins and minerals to function properly. What happens when you don’t get enough of them? What happens when you eat too little food, or when the food you eat isn’t sufficiently nutritious? Perhaps our bodies catch on and reply by increasing hunger levels. After all – if we eat more, we increase the chances of consuming enough of whatever nutrient we are lacking.

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.


It is very interesting to read about the keto/low card diet.I love to change my lifestyle as I an TYPE 2 Diabetic.I subscribed for a free printable low carb meal .The initial email stated that that I will receive an email for instructions to access the members area .Your free download will be there.However it is very deceiving ,I never got the 2nd email with instructions which is frustrating and not good .Hopefully this is not a way to get us to pay to get the printable version.
Now, about that whole low-fat and low-sugar thing. It can be tricky come dessert time, but Gorin has a hack for surviving that as well: "One way to feel like you’re getting the dessert that you crave while still following the diet is to eat a fruit-based 'nice cream,' like my chocolate-banana recipe. By combining frozen bananas and unsweetened cocoa powder, you'll wind up with a treat that resembles the texture of ice cream yet contains no added sugar and also counts toward your daily fruit servings."
As I wrote in op-eds for the Wall Street Journal61 and Medscape,62 the Lancet Public Health study is based on very thin data. The questionnaire underlying the report left out questions regarding popular foods, such as pizza and energy bars, and did not consider alcohol consumption. Moreover, the “low-carb” diet group in this study included people eating up to 37% of calories as carbohydrates—not low-carb according to the latest science. Ultimately, this is the kind of data that can show association but not establish causation, which means it is the kind of data one can use to generate hypotheses but not prove them. This kind of data would never be considered sufficient to approve a drug, for instance. The same standards should be applied to diet. Quite a few researchers, including myself, had our critiques published in Lancet Public Health.63 The authors replied but did not respond to most of the criticisms.

So my question to all of you is: why do most people trying to improve their health appear to not care at all about how their food choices impact the earth and the future of all our children? (Not to mention the horrific conditions that the great great majority of animals bred for food endure?) Is it because you have not been told or do not believe how bad it is (our society has many many who are in total denial about global warning, for instance), or is it because you truly don’t care?
4. Better eyesight. The diet could help stave off or prevent macular degeneration, the leading cause of vision loss after age 54. The condition, which affects more than 10 million Americans, destroys the part of your retina responsible for the clear central vision you need to read, drive, and recognize faces. A recent study linked eating fish and vegetables to a reduced risk of getting it early, and the omega-3 fatty acids in fish can lower the risk of the disease altogether. What's more, the lutein in green leafy vegetables cuts your chance of cataracts and boosts retinal health, says Dr. Willett.
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.
Thank you for your comment and your kind words Beverly! The diet you follow is quite restrictive and restricts most foods that are part of the Mediterranean diet. I have not seen any evidence of such a diet being anti-inflammatory. A traditional Mediterranean diet is considered an anti-inflammatory diet. The arthritis foundation also recommends a Mediterranean diet (https://www.arthritis.org/living-with-arthritis/arthritis-diet/anti-inflammatory/anti-inflammatory-diet.php). You can also check this article from Harvard for additional insight: https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation
Dr. Reynolds reviewed numerous research studies on ketogenic diets,6 and he has found that most studies show that the drop in blood sugar is typically short-term—only lasting during the initial three months or so—but does not last.  "So it is very hard to encourage ketogenic diets when we have no evidence that they work over longer periods of time," he tells EndocrineWeb.

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.
Now I have to say, I am not a supporter of rigid plans, however it is important to eat at somewhat regular times so you don’t end up feeling very-very hungry at any particularly moment of the day. Having said that, I also think it is important to be able to actually feel hunger, and look forward to eating a meal.  While adding a snack here and there is good to keep blood sugar and hunger levels in balance, snacking can also backfire. Many times we eat a snack without being hungry or we depend on ready-made snacks such as granola bars, juices, smoothies etc. which not only add quite a few calories but also are a processed food with all that entails.
I’ve been there and have tried the Ketogenic Diet. It’s very difficult even though I am a very determined and goal oriented person. When I set my mind up to do something, I will normally achieve it because I am just so stubborn about personal goals that I don’t give up until I do! Yes, you will lose a lot of weight quickly, but I am not interested in giving up bread, pasta and birthday cake for the rest of my life.

While there isn't "a" Mediterranean diet, most versions share many of the same principles. According to Oldways, the nonprofit food think tank in Boston that helped develop a Mediterranean food pyramid, you'll load up on fruits, veggies, whole grains, nuts and legumes; eat plenty of fish and seafood; get a little poultry, eggs, cheese and yogurt; and mostly pick at sweets and red meat. And don't forget a drizzle of olive oil and (if you want) a couple glugs of wine.
Type 2 diabetes is one of the most pressing challenges of our time and its ultimate cause has not been fully understood. Ketogenic diets, which are low in carbohydrate and high in fat, are known to lead to weight loss and have been considered to be healthy. These findings raise new questions about ketogenic diets and whether or not they are actually healthy.

Congratulations to you!! Keep up the good work. And, I have to say again, choosing the keto way of life as a type one diabetic is a lot easier than one would think, right?!. It is so rewarding, as you point out, and actually quite easy (lose the carb cravings and enjoy eating everything that you can!). I honestly feel more FREEDOM eating this way than I did eating the other way for 20 years and I love the normal sugars and better energy. Also the decrease in inflammation is awesome.
In my food shopping we save about $40 a week even though we eat seafood twice a week. A fillet of salmon or swordfish that feeds two is about the same price of the cut of steak that I would grill for myself. Preparing snacks on Sunday night also means no more trips to the office vending machine for that late-day snack. “I joked around with a couple of colleagues last week in my presentation,” Susan mentioned. “I said, ‘You know, we’re paying for diabetes, we’re paying for high blood pressure. Why not invest your money and diet in food sources that are good for you body?'”
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