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.
It is important to note that the research did not analyze whether the diet employed causes obesity, if given long term. The mechanism behind the whole process was undetermined; therefore, the existence of a shared physiological response between low carb and regular carb high fat diets that cause insulin resistance in the liver requires further exploration.
Physicians of ancient Greece treated diseases, including epilepsy, by altering their patients' diet. An early treatise in the Hippocratic Corpus, On the Sacred Disease, covers the disease; it dates from c. 400 BC. Its author argued against the prevailing view that epilepsy was supernatural in origin and cure, and proposed that dietary therapy had a rational and physical basis.[Note 3] In the same collection, the author of Epidemics describes the case of a man whose epilepsy is cured as quickly as it had appeared, through complete abstinence of food and drink.[Note 4] The royal physician Erasistratus declared, "One inclining to epilepsy should be made to fast without mercy and be put on short rations."[Note 5] Galen believed an "attenuating diet"[Note 6] might afford a cure in mild cases and be helpful in others.[11]
I’ve been asked many times to provide an authentic Mediterranean Diet meal plan, and when we say authentic, we mean it! The reason for this is that most “Mediterranean Diet” meal plans I see online are anything but. Sorry, but edamame beans, minuscule amounts of  olive oil, canola oil, meat with every meal etc. are not part of a Mediterranean Diet.
The best diet for losing weight is Weight Watchers, according to the experts who rated the diets below for U.S. News. Volumetrics came in second, and the Flexitarian Diet, Jenny Craig and the vegan diet were third on this overall weight loss ranking list, which takes into account short-term and long-term weight loss scores. Some other diets performed as well or better in our rankings for enabling fast weight loss, but long-term weight loss is more important for your health.
The herbs and spices associated with the Mediterranean diet shine at dinner. Meal options include fish like grilled salmon or pan-seared trout, seasoned with lemon and dill; chicken baked with a little olive oil and rosemary; grilled lamb chops with mint; mussels cooked in a tomato, garlic and wine broth; chili made with ground turkey, kidney beans and cayenne, or vegetarian-style with a mix of beans; and scallops sauteed with mushrooms and leeks. Have a 4-ounce serving of protein, and fill the rest of your plate with cooked veggies, like cauliflower, broccoli, brussels sprouts, or green beans.

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!
So how does this work? A quick run-through: The first tip was to eat low carb. This is because a low-carb diet lowers your levels of the fat-storing hormone insulin, allowing your fat deposits to shrink and release their stored energy. This tends to cause you to want to consume fewer calories than you expend – without hunger – and lose weight. Several of the tips mentioned above are about fine-tuning your diet to better this effect.
Forget old low-carb diet plans that focused on processed protein bars and shakes. This year, the keto diet got high marks for low carb. Keto, short for "ketogenic," is all about training the body to burn fat for fuel. How? By eating fat—and lots of it. Most keto diets recommend getting at least 70 percent of your daily calories from fat and the rest from protein. The goal is to eat as few carbohydrates as possible. Proponents say it helps them drop weight fast with little or no hunger in addition to perks like more energy and mental clarity. (Interested? Here's everything you need to know about the keto diet.)
Hi, Esther! Thank you so much for your kind comment. I am so glad you found The Mediterranean Dish and hope you’ll enjoy cooking some of the recipes here! I should preface my answer here by saying that I am not a dietitian or a nutritionist, what I share here is mainly from my experience as someone who grew up in the Mediterranean area and have continued to eat the Mediterranean way now as an adult living in the USA. So please always check with your health care provider or a registered dietitian if you are looking for professional advice or a specific diet plan to follow. But I’ll answer your questions as best as I know how.
For people with Type 1 Diabetes, you probably have heard of their diabetic emergency, diabetic ketoacidosis, also referred to as DKA. This can be life threatening condition for people with Type 1 diabetes and Certified Diabetes Educators spend many hours teaching preventive care for DKA. This condition should not be confused with nutritional ketosis, the fat burning state reached when following the Ketogenic diet. The two conditions are quite different.

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.)
It seems strange that a diet that calls for more fat can raise “good” cholesterol and lower “bad” cholesterol, but ketogenic diets are linked to just that. It may be because the lower levels of insulin that result from these diets can stop your body from making more cholesterol. That means you’re less likely to have high blood pressure, hardened arteries, heart failure, and other heart conditions. 

102 of these subjects had type 2 diabetes. The subjects were divided into two groups: one consumed a low-calorie diet (LCD) while the other consumed a low-carbohydrate ketogenic diet (LCKD). Both also underwent equal exercise and nutritional training. Every four weeks, the researchers measured levels of waist circumference, blood glucose level, levels of glycosylated hemoglobin, and triglycerides.
HCG, or Human Chorionic Gonadotropin, is a hormone produced during pregnancy by the placenta after implantation, and doctors sometimes prescribe it for fertility issues. But this hormone has also gained popularity as a weight-loss supplement — and using it as such can be dangerous. In fact, the U.S. Food and Drug Administration (FDA) warns against purchasing over-the-counter hCG, as these supplement products are illegal. (34)
Grains and beans are some of the most carbohydrate-dense foods out there, so breads, rice, and beans will spike your blood sugar causing crashes and cravings later on. There’s more to the issue with grains and beans, though. They contain some proteins and compounds that humans just don’t handle well. Here’s a breakdown of some of the issues with grains and beans.
Type I diabetes is usually inherited and type I diabetics usually have to inject insulin to maintain proper levels of blood glucose. The other 90% to 95% of people with diabetes are type II diabetics. [1] In this version, the body doesn’t produce enough insulin for proper function or cells in the body do not react to insulin and take in sugar from the blood.
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)
The idea is that the fasting induces mild stress to the cells in your body, helping them become better at coping with such stress and possibly helping your body grow stronger. The verdict is still out regarding the diet’s long-term effectiveness with weight loss, according to a review of preliminary animal research published in January 2017 in Behavioral Sciences. (17)
What the diet advocate says: 'The classic keto diet was very strict and nowadays what’s become more popular even to use from a clinical scenario is called the Modified Keto diet which is more liberal in protein. And that’s generally what people are following for weight loss and energy. That would be roughly 65-70% fat, 20-30% protein with a very small carb amount 5-10%,’ says Dr Dominic D’agostino, professor of neuropharmacology at the University of South Florida.
My husband and I have been doing this diet for a while now. And let me tell you it works. He has lost weight and his blood pressure has gone down!! It isn't a hard diet at all, the first 2 weeks you learn to live without carbs , but that isn't to bad. The 2nd phase you start adding some carbs back along with other foods. It's all about making the right choices.
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)
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.
According to the official DASH Diet Weight Loss Solution page, this eating plan actually turbocharges the original DASH diet by further reducing added sugars, refined grains, and heavily-processed foods. It also includes some specific guidelines for weight loss, such as making colorful vegetables the center of your meals and adding fresh fruits to your plate whenever you get a craving for sweets.

Salmon boasts significant anti-inflammatory properties thanks to its rich omega-3 fatty acid content, meaning it’s an excellent source of protein for those looking to jumpstart their weight loss. In fact, one study that examined the effects of weight loss and seafood consumption showed wild salmon to be the most effective at reducing inflammation—better than lean white fish and a fish-free diet. According to a study published in The Journal of Nutritional Biochemistry, fishy fatty acids may also signal thyroid cells in the liver to burn more fat.
Although white potatoes offer some potassium and fiber, sweet potatoes reign supreme in the nutrition department, meaning you should consider adding sweet potatoes to your diet. A large sweet potato contains around 4 grams of satiety-boosting protein, 25 percent of the day’s belly-filling fiber, and 11 times the recommended daily intake of vitamin A. What’s more? It’s less than 200 calories.
On day 1, have a cup of plain low-fat Greek yogurt for breakfast, topped with 1/2 cup of blueberries and an ounce of chopped walnuts. The yogurt gives you calcium and satisfying protein, while the berries are full of antioxidants that protect you against cellular damage, and the nuts supply heart-healthy omega-3 fats. Have yogurt on day 4, too, but try pomegranate seeds and chopped pistachios -- or sliced oranges and chopped almonds.

Yes, peanut butter is high in calories, but if you stick the real stuff—a tasty combo of peanuts and maybe a touch of salt—the legumes can work their weight loss magic. In addition to providing you with belly-slimming monounsaturated fats, tummy-filling fiber, and metabolism-boosting protein, peanuts also contain genistein, a compound that helps turn down the genes for obesity and reduces your body’s ability to store fat.


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


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.)
I LOVE your recipes and entire program! You simplify eating healthfully and your recipes look delicious. I have arthritis and must eat a restricted diet that is anti-inflamatory. I can easily see ways to adapt some of your recipes. The diet forbids grains, beans, wheat, chick peas, potatoes, pasta, or any fruits or vegetables with seeds, etc. I was skeptical about this diet at first but if I stick to the diet, I really do experience less pain. I would so wish to have your recipes adapted for the home cook with substitutions of allowed foods for the forbidden. For instance, I am going to try to make your phyllo recipe using almond flour, and in other recipes using only pasture grazed dairy such as goat and sheeps milk cheeses, yogurts, eggs etc. Thank your for your inspiration and I would be so grateful if you would turn your gifted cooking attention to helping those of us in pain to adapt your delicious and healthful diet to include anti-inflamation recipes. There is a huge and eager market for this.

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.
Use fat as a lever.  We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied.
What the expert says: ‘This is something that is used for athletes as part of their training. While it can lead to weight loss, carbohydrates are an energy source for the body, and restricting them can lead to headaches, fatigue and difficulty concentrating. You would be better to find the level of carbohydrates your body needs by eating normal portion sizes and a balance of all food groups.’

Whole grains: They contain more vitamins, minerals, and protein than white-flour products and have a stabilizing influence on blood-sugar levels. Experiment with nutrient-dense, nutty-tasting exotic whole grains such as barley, amaranth, quinoa, and faro. But watch your intake: One cup of cereal equals two servings, as do two slices of pumpernickel bread.
Finally, people eat about nine servings of fruits and vegetables a day on a Mediterranean diet. (1) Produce packs an array of disease-fighting antioxidants, and people who fill their diet with these foods have lower risk of disease. Yet as the National Institutes of Health points out, it’s not known if it’s the antioxidants or other compounds (or general healthy eating patterns) that are responsible for these advantages. (5)

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.)
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 am one of those strange people that enjoys reading about nutrition. I chose this book merely for this "diet" being listed as number one for the past few years. While I completely agree with the majority of the principals there are a few things I found disturbing. No coconut oil? However, margarine, Sugar free jello, low fat dairy products, diet drinks, and artificial sweeteners are promoted in this plan. Seriously? I am by no means a Purist but to put sugar free jello on a daily meal plan?
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.
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.
You may have noticed a bit of an explosion of gluten-free offerings on your grocery store shelves. Some may call it a trend, but over the last 70 years there’s been a steady increase in the number of people who don’t tolerate gluten or other grain proteins.[19] People with a sensitivity, intolerance or full-on Celiac disease experience any combination of brain fog, inflammation, fatigue, joint pain, and gut issues – and they tend to resolve simply by avoiding grains.[20]
We do recommend everyone eat something every 4-5 hours to maintain a healthy metabolism. If your meals are more than 4-5 hours apart, a snack consisting of a protein and a carbohydrate is a great choice. The protein will help fill you up quicker and keep you feeling satisfied between meals. The protein also has a slower effect on your blood glucose than most carbohydrates, so when paired with carbohydrates, your blood sugar will not spike nearly as high. We recommend eating a protein with every meal and snack.

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.”
But what I think is funny is that the keto diet has been staring us in the face forever. Look at Inuit tribes that survived off of blubber in a region that grows next to nothing most of the year. Yet their people didn’t die out or show signs of metabolic disorders or heart disease until introduced to the modern western diet that prioritizes carbohydrates over fat. Here is an interesting link, however I find the conclusion disheartening and frankly more than a little suspicious. (Basically the people in charge decided to drop the study and introduced a bunch of “what about…” questions to obfuscate a clear pattern in observation across many indigenous people from across the face of the planet and decided the outcome “wasn’t enough” to introduce into public policy…)

Other diabetes medications. Insulin-releasing tablets (e.g. sulphonylureas) often lead to weight gain. These include: Minodiab, Euglucon, Daonil, and Glibenclamide. Tablets like Avandia, Actos, Starlix and NovoNorm also encourage weight gain. But not Metformin. The newer drugs Victoza and Byetta (injectable) often lead to weight loss, but possible long-term side effects are still unknown. More on diabetes
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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