The keto diet is intriguing because it appears to run counter to the prevailing wisdom about the importance of lowering fat intake to prevent diabetes and heart disease, says a co-author of the new study, Gerald Grandl, PhD, a postdoctoral researcher at the Institute for Diabetes and Obesity at the Helmholtz Center in Munich. ETH Zurich conducted the study with University Children's Hospital Zurich.
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When the data were examined, it was clear that people who ate a diet where fruits and vegetables, grains, beans, and fish were the basis of daily meals were healthiest. Topping the chart were residents of Crete. Even after the deprivations of World War II – and in part, perhaps, because of them –  the cardiovascular health of Crete residents exceeded that of US residents. Researchers attributed the differences to diet.
While body weight decreased significantly (-8.5 kg) in these 21 diabetic participants, the mean weight loss was less compared with what we observed in the LCKD participants of an earlier trial (-12.0 kg) [18]. Given that the diabetic participants had a higher baseline mean weight than the LCKD participants of our previous trial (131 kg vs. 97 kg), this translates into an even more dramatic disparity in percent change in body weight (-6.6% vs. -12.9%). This lesser weight loss might result from several factors. First, in the current study, most of the participants were taking insulin and/or oral hypoglycemic agents that are known to induce weight gain[20,21] Second, these same agents, particularly insulin, inhibit ketosis, which is strived for in the earliest phases of the LCKD; while it remains unclear whether ketones actually play a role in weight loss on the LCKD, previous research in non-diabetic patients has shown a positive correlation between level of ketonuria and weight loss success [22]. Lastly, compared with our previous study the participants in the current study had more comorbid illness, lower socioeconomic status, and a shorter duration of follow-up (16 weeks versus 24 weeks), all of which are associated with reduced success on any weight loss program [23].

“As soon as you start consuming a normal amount of carbohydrates again, you immediately go out of ketoacidosis or the fat burning state”. I am sure you know the difference between nutritional ketosis and ketoacidosis yes? One is the natural fat burning state, and the other is toxic. Right now i am in ketosis but not ketoacidosis. One has a natural balance of Ph level, the other not. Once you make that statement, i have a sick feeling i am not getting the right information here.
January 6, 2016 "What makes a diet best? In Best Diets 2016, the latest set of exclusive rankings from U.S. News, the DASH diet beat out 37 others.  To be top-rated, a diet had to be relatively easy to follow, nutritious, safe, effective for weight loss and protective against diabetes and heart disease. The government-endorsed Dietary Approaches to Stop Hypertension (DASH) snagged the top spot."

Where is the science? And if insolin intolerance is a diabetic problem why keep trying to regulate insolin? The stuff isn’t working because your patients are not getting better just deteriorating slower while you make more money keeping them on drugs!!!!! Your hole point is ketosis is bad cause they don’t have to see you after they adjust off the medication that keeps them having to see people like you!!! I have been eating keto for 6 months and feel amazing!!! These people are twisting the truth to keep you sick for there own pockets!!!!!!

This article is a perfect example of the misinformation regarding diabetes and insulin resistance. The authors stance against the ketogenic diet is a simple, “its just too hard, I cant live without fruit.” She projects her lack of willpower to her audience. Ketogenic diets are a great way to reduce insulin levels and get to the root of the problem.
Epilepsy is one of the most common neurological disorders after stroke,[7] and affects at least 50 million people worldwide.[8] It is diagnosed in a person having recurrent unprovoked seizures. These occur when cortical neurons fire excessively, hypersynchronously, or both, leading to temporary disruption of normal brain function. This might affect, for example, the muscles, the senses, consciousness, or a combination. A seizure can be focal (confined to one part of the brain) or generalised (spread widely throughout the brain and leading to a loss of consciousness). Epilepsy may occur for a variety of reasons; some forms have been classified into epileptic syndromes, most of which begin in childhood. Epilepsy is considered refractory (not yielding to treatment) when two or three anticonvulsant drugs have failed to control it. About 60% of patients will achieve control of their epilepsy with the first drug they use, whereas about 30% do not achieve control with drugs. When drugs fail, other options include epilepsy surgery, vagus nerve stimulation and the ketogenic diet.[7]
A low carb diet plan is a way of eating that is high in fat, moderate in protein and low in carbohydrates. There are different variations of low carb, and the keto diet is a special type of low carb with added characteristics. The number of carbohydrates will vary depending on your insulin tolerance and activity level, but on average, these are the common numbers of carbs:
It is important to understand that the statement that carbohydrates are “nonessential” is not only factually inaccurate, it results in adopting a low-carbohydrate diet or ketogenic diet that increases your risk for a wide variety of chronic health conditions that may ultimately shorten lifespan, decrease your quality of life, and accelerate your risk for chronic disease.
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.’

There’s also some evidence that it might help with type 2 diabetes. “An emerging body of research is finding that a keto plan may have some real benefits thanks to its ability to improve the body’s ability to use insulin and also help control appetite, which can result in easier weight loss,” says Karen Ansel, R.D.N., co-author of Healthy in a Hurry.
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There are theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child's meal. In many countries, food labelling is not mandatory so calculating the proportions of fat, protein and carbohydrate is difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.[53]
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!
“We have basically no evidence that this diet is consistent with human health over time,” says Dr. Katz. (Its heavy emphasis on animal protein isn’t ecologically sustainable, either, he adds.) “All of the evidence we have points toward a plant-predominant diet with an emphasis on vegetables, whole grains, fruits, nuts, and seeds—all of the very things that the ketogenic diet avoids.”
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?'”
Urine ketone data were missing in a median of 4 participants (range 0–8) at any given visit. The proportion of participants with a urine ketone reading greater than trace was 1 of 17 participants at baseline, 5 of 17 participants at week 2, and similar frequencies at subsequent visits until week 14 when 2 of 18 participants had readings greater than trace and week 16 when 2 of 21 participants had readings greater than trace. During the study, only 27 of 151 urine ketone measurements were greater than trace, with one participant accounting for all 7 occurrences of the highest urine ketone reading (large160).
Make things yourself. While it’s extremely convenient to buy most things pre-made or pre-cooked, it always adds to the price per pound on items. Try prepping veggies ahead of time instead of buying pre-cut ones. Try making your stew meat from a chuck roast. Or, simply try to make your mayo and salad dressings at home. The simplest of things can work to cut down on your overall grocery shopping.
I hate reading, but this book is laid out so you can use it in whatever way you want. It has recipes in one section, or example meal plans in another. I skipped a lot of the actual reading, and used it for all the resources it contained, This helped save me time, so I could get down to business. After the first week I was down 8 lbs. I look forward to continuing my journey. Btw the index is your friend.
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!

Because some cancer cells are inefficient in processing ketone bodies for energy, the ketogenic diet has also been suggested as a treatment for cancer.[58][59] A 2018 review looked at the evidence from preclinical and clinical studies of ketogenic diets in cancer therapy. The clinical studies in humans are typically very small, with some providing weak evidence for anti-tumour effect, particularly for glioblastoma, but in other cancers and studies, no anti-tumour effect was seen. Taken together, results from preclinical studies, albeit sometimes contradictory, tend to support an anti-tumor effect rather than a pro-tumor effect of the KD for most solid cancers.[60]
WH verdict: It’s still a diet by any other name, but props to Weight Watchers for acknowledging that there’s more to being healthy than ‘weight’. The new platform really does consider all aspects of wellness. And with plans to partner with Alexa and Google Assistant to help track your progress, WW could be to 2019 what Weight Watchers was to the early noughties.
I know it is hard when you have been taught something, and believed it, and taught it to others…only to be shown that what you have been taught is not the end all be all that you were led to believe. It sucks. But, you can choose to ignore the truth, and continue to follow the incorrect path. Or, you can look at the facts, and realize that what you have been taught is not the truth…and you can take a new path, which will lead many to wonderful new lives.
Fuels and feeds your brain: Ketones provide an immediate hit of energy for your brain, and up to 70% of your brain’s energy needs when you limit carbs.[6] Fat also feeds your brain and keeps it strong. Your brain is at least 60% fat, so it needs loads of good fats to keep it running.[7] Essential fatty acids such as omega-3s help grow and develop the brain, while saturated fat keeps myelin — the layer of insulation around the brain — strong so your neurons can communicate with each other.
The ketogenic diet is not a benign, holistic or natural treatment for epilepsy; as with any serious medical therapy, there may be complications.[27] These are generally less severe and less frequent than with anticonvulsant medication or surgery.[27] Common but easily treatable short-term side effects include constipation, low-grade acidosis and hypoglycaemia if there is an initial fast. Raised levels of lipids in the blood affect up to 60% of children[37] and cholesterol levels may increase by around 30%.[27] This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and, if persistent, by lowering the ketogenic ratio.[37] Supplements are necessary to counter the dietary deficiency of many micronutrients.[3]

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.

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.
A keto diet was/ is not just used for diabetics. It is a very useful tool for epilepsy. It is extremely successful in reducing the number of seizures per day, mainly in children but also in adults. I am sure that followers of the epilepsy diet, which has been used since the 1920s have not all starved to death. Iwould also think that the followers of this diet are also motivated to stay on it, not eat a slice of birthday cake and keep all thier brain cells.
Hi Gigi, Low carb and keto is about the balance of macronutrients eaten (fat, protein and carbs), not specifically meat or lack thereof. Most people on keto do eat meat, though some people do vegetarian keto. Fat is actually necessary for many body processes. There is no issue for the kidneys with a high fat diet, but if you eat too much protein that isn’t great for the kidneys. It’s a common misconception that keto is high protein (it isn’t). Keto is great for diabetics as it naturally helps stabilize insulin. All of this being said, please know I’m not a doctor and you should consult your doctor on any medical questions or before starting any diet. If you have more questions that aren’t medical questions, I recommend our low carb & keto support group here.
Control portion size. Ideas for how to do this include downsizing your dishes, eating without watching TV or being otherwise distracted, and keeping unhealthy food out of sight. An important component of the DASH diet is also to eat smaller portions more frequently throughout the day. This is a way to reduce the risk of overeating and to distribute your energy evenly during the day.
Bueno NB, de Melo ISV, de Oliveira SL, da Rocha Ataide T; “Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomized controlled trials” (2013) British Journal of Nutrition 110(7): 1178-1187. Accessed 4/23/2018 https://www.cambridge.org/core/services/aop-cambridge-core/content/view/6FD9F975BAFF1D46F84C8BA9CE860783/S0007114513000548a.pdf/verylowcarbohydrate_ketogenic_diet_v_lowfat_diet_for_longterm_weight_loss_a_metaanalysis_of_randomised_controlled_trials.pdf
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.
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.

I have patients that have lost tons of weight on keto. They do go off some meds. I also have people who eat a moderate amount of good carbohydrates, and they have lost tons of weight, and been taken off meds, had improved markers, even reversal. I think both approaches work, as I have seen in practice. Many people cannot stay on a keto diet forever. I for one, prefer to have some carbohydrates. I try to pick the right ones. If this works for you, then just be sure to have some medical supervision, which it sounds as though you are doing.

I suffered through a year on 20 grams of carbs per day and it was the worst year of my life. Yep, I lost weight, but at my current weight of 130 lbs and eating 30 carbs per meal and remaining in a prediabetes state for 15 years, I am healthy AND happy now. None of us know the long term effects of most of what is offered to us…medications, diet drinks, processed foods, restrictive diets. The point I was trying to make was eating healthier, more natural foods will be better in the long run, I believe we all have the common sense to agree on that, even if we can’t agree on how many carbs we will eat!
Of the 28 participants enrolled in the study, 21 completed the 16 weeks of follow-up. Reasons for discontinuing the study included unable to adhere to study meetings and unable to adhere to the diet; no participant reported discontinuing as a result of adverse effects associated with the intervention. All but one of the 21 participants were men; 62% (n = 13) were Caucasian, 38% (n = 8) were African-American (Table ​(Table1).1). The mean age was 56.0 ± 7.9 years.
The problem is: it flies in the face of the way we have been taught. Our society (as an American), and our medical community, have preached for years that FAT is bad, and you should limit it. However, recent FACTS beg to differ. So many people rail against the keto diet because they just feel that it can’t be good…after all, you eat so much fat on it, it can’t be good for you! Facts are facts…they don’t care about your feelings. Fat is not the enemy. Sugar is.
In her book, Susan highlights one of the major problems with dinner time today: quality time. Does everyone else remember when dinner time was family time? When we would all sit down together, share our day, talk, laugh, and leave when the meal was done? Susan and I shared our childhood dinning experiences when we discussed her call for embracing the the Mediterranean lifestyle — incorporating exercise, relaxation, and family meals back into our daily routines. This book is looking for someone who is looking to make a lifestyle choice. The way that you eat, sitting down with your families at the dinner table. No more meals on the go, no more meals with the TV. I wanted to bring back the importance of food in our households,” noted Susan.

“This is a great way of eating that I highly recommend to many clients, and I even model in my own life,” says Elizabeth Shaw, RDN, who is in private practice in San Diego and is the co-author of Fertility Foods Cookbook. “Since the premise of the diet is designed to help people who have high blood pressure, low-sodium foods are recommended. But considering that most Americans exceed their daily sodium levels anyway, it’s not surprising that dietitians recommend this style of eating for treating many different conditions, such as heart disease and obesity.”
Based on long-overlooked DASH research and developed into a weight loss plan by the foremost DASH dietitian and leading nutrition expert, Marla Heller, MS, RD, this effective and easy weight loss program includes menu plans, recipes, shopping lists, and more. Readers will enjoy a diet rich in fruits, vegetables, low-fat and nonfat dairy, lean meats/fish/poultry, nuts/beans/seeds, heart healthy fats, and limited amounts of whole grains. The result: improved metabolism, lower body fat, improved strength and cardiovascular fitness, without counting calories. And, of course the DASH diet can lower cholesterol and blood pressure without medication!
If the diet is a quick fix rather than one that promotes lasting lifestyle changes, this could pose a problem. In particular, extreme diets that promise big weight loss up front aren’t always sustainable — and you may end up overeating or even binge eating if you feel deprived. “Consider if the diet’s habits are ones you can continue throughout your lifetime, not just 21 or 30 days,” says Angie Asche, RD, a sports dietitian in Lincoln, Nebraska.
This is a great site for information, details, recipes, etc… one of the reasons I started looking into this way of eating is my husband suffers from high blood pressure, cholesterol and type 2 diabetes. We are not exceptionally overweight, however could both use to lose 10-15 lbs/ea. I also have facial and ocular rosacea and have heard good things about this way of eating for an overall improvement in numerous areas. Although I may have missed it I haven’t seen anywhere you might have mentioned your weightloss success. Thank you for sharing your wealth of information.

Yancy WS Jr, Westman EC, McDuffie JR, Grambow SC, Jeffreys AS, Bolton J, Chalecki A, Oddone EZ, “A randomized trial of a low-carbohydrate diet vs orlistat plus a lowfat diet for weight loss,” Arch Intern Med. 2010 Jan 25;170(2):136-45. http://www.ncbi.nlm.nih.gov/pubmed/20101008?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2.
With fats being my main source of calories, my body and energy levels have never been better. When I educated myself on it and understood the science behind it, it was clear to see why my joints started feeling better, and ailments started to go away. I now have more “oil” lubricating my cells so they’re more receptive/flexible/malleable to the nutrients in my foods. People can loose weight very fast, but honestly the first 10lbs or so is a lot of water weight so that’s really nothing to write home about.
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.
Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures and kidney stones.[3] The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone.[37] About 1 in 20 children on the ketogenic diet will develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone.[38] The stones are treatable and do not justify discontinuation of the diet.[38] Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in a sevenfold decrease in the incidence of kidney stones.[39] However, this empiric usage has not been tested in a prospective controlled trial.[9] Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:[38]

Similar to our results, three studies noted that diabetes medications were reduced in some participants[6,8,9], although details were provided in only one study. We also discontinued diuretic medications during diet initiation because of concern for additional diuresis incurred by the diet. This concern was based on the theoretical effects of the diet [17], observed effects of the diet on body water by bioelectric impedance [18], and practical experience with the diet [19]. Until we learn more about using low carbohydrate diets, medical monitoring for hypoglycemia, dehydration, and electrolyte abnormalities is imperative in patients taking diabetes or diuretic medications.
It is important to understand that the statement that carbohydrates are “nonessential” is not only factually inaccurate, it results in adopting a low-carbohydrate diet or ketogenic diet that increases your risk for a wide variety of chronic health conditions that may ultimately shorten lifespan, decrease your quality of life, and accelerate your risk for chronic disease.
If you’re looking to get a jump start on your health and fitness goals this year, you may be thinking about trying the ketogenic diet. Maybe you’ve heard the phrase before — it’s a huge diet buzzword — but aren’t sure what it means. Here’s a primer: The ketogenic diet is an eating plan that drives your body into ketosis, a state where the body uses fat as a primary fuel source (instead of carbohydrates), says Stacey Mattinson, RDN, who is based in Austin, Texas.
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