Net carbs is simply total carbs minus fiber and non-digestible sugar alcohols, like erythritol. (This doesn’t apply to high glycemic sugar alcohols, like maltitol.) We don’t have to count fiber and certain sugar alcohols in net carbs, because they either don’t get broken down by our bodies, are not absorbed, or are absorbed but not metabolized. (Read more about sugar alcohols here.)
Thanks to its flexibility, easy-to-understand system, and group support, Weight Watchers came out way (weigh?) ahead, winning "best weight loss," "best fast weight loss," and "best commercial diet" in the U.S. News & World Report rankings. (Oprah's endorsement probably didn't hurt either!) They recently revamped their signature plan to include "free" foods like chicken breasts and fresh produce so you'll never feel hungry even while dropping pounds. In addition, their app makes tracking your food a piece of cake—which you're totally allowed to have on the program, by the way. (Even better news: Research supports the fact that Weight Watchers is one of the best weight-loss diets.)
Also, to the author I do appreciate you stating you are bias up front, but I do get to indulge with some fruit/berries when I want. You dont give up everything forever but you learn to fit them into your macros. I have learned to make Keto ice cream and fat bombs if the urge comes along. I have learned to take keto friendly foods along to potlucks that everyone loves. Keto can be a way to follow forever but everyone has their own needs for their bodies. I am new to this but finding it easier and easier to remain keto
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.
I must tell you when looking at this link they say the American Diabetes Association Guidelines call for 60-75 carbohydrates per meal and that is simply not true. The ADA has recommended since 2013 we use our best clinical judgement in recommending a low carbohydrate diet for people with diabetes, recognizing it needs to be individualized. 60-75 grams is the carbohydrate amount I would give to a very tall, large boned man or perhaps an active teen or young adult. I would never recommend that many carbohydrates for an average size man who was trying to lose weight; he would get 45-60 grams of carbohydrates per meal and 15-30 grams for snacks. A women trying to lose weight would get 30-45 grams of carbohydrates per meal and 15 grams for snacks.
The ketogenic diet may offer hope to people with type 2 diabetes who have difficulty controlling their symptoms. Not only do many people feel better with fewer diabetic symptoms, but they may also be less dependent on medications. Still, not everyone has success on this diet. Some may find the restrictions too difficult to follow over the long term. Yo-yo dieting can be dangerous for diabetes, so you should only start the ketogenic diet if you’re sure you can commit to it. A plant-based diet may be more beneficial for you both short- and long-term, so input from your dietitian and doctor can help guide your diet choice.

At first glance the ketogenic (keto) diet may seem like a crazy idea for type 2 diabetics. After all, many patients are put on diets to help them lose weight. The keto diet is high in fat, but it is very low in carbs, and this combination can help change the way your body stores and uses energy. With this diet your body converts fat instead of sugar into energy, which can improve blood glucose levels while reducing the need for insulin.


“Instead of using a heavy salad dressing, try a drizzle of thick balsamic glaze along with a squeeze of fresh lemon or lime juice” Taub-Dix says. “By cutting the fat in your diet, you can not only save calories, but you can also leave room for healthier fats like avocado or nuts, which are toppings you can actually chew and enjoy with greater satisfaction.”
You’re transitioning. Your body is equipped to process a high intake of carbs and a lower intake of fat. Your body needs to create enzymes to be able to do this. In the transitional period, the brain may run low on energy which can lead to grogginess, nausea, and headaches. If you’re having a large problem with this, you can choose to reduce carb intake gradually.
A small, randomized crossover study published in the Journal of Diabetes Sciences and Technology found that after three months, people who followed a modified, low-carb paleo diet saw greater reductions in their A1C, their triglycerides, their diastolic blood pressure, and their weight than those who followed a traditional diabetes diet. (The approach also increased their levels of LDL, or "good” cholesterol.) The diabetes diet in the study involved consuming no more than 6 g of salt per day, reducing saturated fat and total fat intake, and upping intake of veggies, fiber, whole grains, fruits, and veggies. Compared with the diabetes diet, the paleo diet involved eating less dairy, beans, potatoes, and cereals, and more veggies, fruit, meat, and eggs.
The keto diet isn’t new, and it’s been around for nearly a century. It was originally developed to treat people with epilepsy. In the 1920s, researchers found that raised levels of ketones in the blood led to fewer epileptic seizures in patients. The keto diet is still used today to treat children with epilepsy who don’t respond well to anti-epileptic drugs.[2]
The Ketogenic Diet is a low carbohydrate diet, consisting initially of less than 20 carbohydrates per day. Not per meal, yes, you heard me correctly, per day. It is not for the faint of heart and yes I am writing from experience. Of course I have tried it! Hasn’t everybody in America at some point who has wanted to lose weight? Does it work you ask? Of course it does! The problem is how long can you keep it up?
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).
The aim is far broader than suggested by the article here: It’s not just about what you put in your mouth – it’s also about timing and exercise. There are three ways to be in ketosis – which simply means that “fat burning” and not being dependent on sugars. Fasting puts a man into ketosis in 3 days and a woman by 2 days. Endurance exercise gets you there in a couple of hours. Eating a high fat diet will do it too. The goal however is hidden by the detail – it is to acquire a “Flexible Metabolism”. The aim is to switch on the full fat burning capacity and keep it running – which takes from between 4 to 12 weeks physical adaptation (for the muscles to fully be able to use ketones). The heart runs approximately 27% more efficiently on ketones than on glucose! The brain works better too – Alzheimer’s being referred to by researchers as “diabetes 3”. Once you have a Flexible Metabolism you can consume carbs during or after exercise without dropping out of ketosis – though this depends on your own bio-individuality. I can eat quite a lot of carbs – without losing ketosis – my partner cannot.
“Instead of using a heavy salad dressing, try a drizzle of thick balsamic glaze along with a squeeze of fresh lemon or lime juice” Taub-Dix says. “By cutting the fat in your diet, you can not only save calories, but you can also leave room for healthier fats like avocado or nuts, which are toppings you can actually chew and enjoy with greater satisfaction.”
In the study, the researchers fed mice a ketogenic diet for several days and expected to find a favorable outcome — perhaps weight loss or another indication of improved health. Instead, they found that the liver began resisting insulin almost immediately and the mice were unable to regulate their blood sugar levels after only three days on the diet. (Insulin resistance, meaning that cells in the body don't respond to insulin, is a key characteristic of type 2 diabetes.)

Fits in with the principles of eating and activity that I would recommend to clients: lots of produce-based meals and calcium-containing foods three times daily and exercise. Recipes look tasty. I would not necessarily recommend the lead-in period, but I like the meal plans main phase for losing weight as well the maintenance phase. I would recommend to friends and family as well

In fact, patients with gastroesophageal reflux disease (GERD) have been shown to improve after eating very low carbohydrate diets.31, 32 Another study found increased carb-intake worsened GERD, while a high-fat, low-carbohydrate diet reduced symptoms.33 And two studies have linked esophageal diseases, including Barrett’s esophagus (BE)34 and GERD,35 to sugar and carbohydrate intake.
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.
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.

The ketone bodies are possibly anticonvulsant; in animal models, acetoacetate and acetone protect against seizures. The ketogenic diet results in adaptive changes to brain energy metabolism that increase the energy reserves; ketone bodies are a more efficient fuel than glucose, and the number of mitochondria is increased. This may help the neurons to remain stable in the face of increased energy demand during a seizure, and may confer a neuroprotective effect.[55]
Recently, four studies have re-examined the effect of carbohydrate restriction on type 2 diabetes. One outpatient study enrolled 54 participants with type 2 diabetes (out of 132 total participants) and found that hemoglobin A1c improved to a greater degree over one year with a low-carbohydrate diet compared with a low-fat, calorie-restricted diet [5,6]. Another study enrolled 8 men with type 2 diabetes in a 5-week crossover outpatient feeding study that tested similar diets [7]. The participants had greater improvement in glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet. The third study was an inpatient feeding study in 10 participants with type 2 diabetes [8]. After only 14 days, hemoglobin A1c improved from 7.3% to 6.8%. In the fourth study, 16 participants with type 2 diabetes who followed a 20% carbohydrate diet had improvement of hemoglobin A1c from 8.0% to 6.6% over 24 weeks [9]. Only these latter three studies targeted glycemic control as a goal, and two of these were intensely-monitored efficacy studies in which all food was provided to participants for the duration of the study [7,8]. Three of the studies [6,8,9] mentioned that diabetic medications were adjusted but only one of them provided detailed information regarding these adjustments [9]. This information is critical for patients on medication for diabetes who initiate a low-carbohydrate diet because of the potential for adverse effects resulting from hypoglycemia.

Klein S, Sheard NF, Pi-Sunyer S, Daly A, Wylie-Rosett J, Kulkarni K, Clark NG. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. Am J Clin Nutr. 2004;80:257–263. [PubMed]


1- Eliminate fast foods. For many of us living in America, this is one of the tougher adjustments and may take some time. To start with, try swapping a fast-food meal with a homemade one. For example, if it’s chicken wings you crave, make them Greek-style like in this recipe! Or if it’s sweet potato fries (my personal guilty pleasure), try baking them in olive oil with a sprinkle of Mediterranean spices like in this recipe. And So on!
The nerve impulse is characterised by a great influx of sodium ions through channels in the neuron's cell membrane followed by an efflux of potassium ions through other channels. The neuron is unable to fire again for a short time (known as the refractory period), which is mediated by another potassium channel. The flow through these ion channels is governed by a "gate" which is opened by either a voltage change or a chemical messenger known as a ligand (such as a neurotransmitter). These channels are another target for anticonvulsant drugs.[7]
At the conclusion of the intervention, both groups had improved in all metrics but “these changes were more significant in subjects who were on the LCKD as compared with those on the LCD.” [10]. As a result, the researchers supported the study outlined above and concluded that their “…study shows the beneficial effects of a ketogenic diet over the conventional LCD in obese diabetic subjects.” [10]

Although the research has yet to discover all of the mechanisms behind why the keto diet is so helpful for diabetics, these four factors do seem to play a significant role in reducing the severity of type 2 diabetes while also helping with the management of type 1 diabetes. If you’d like to learn more about this topic, consider checking out our article on the keto diet and insulin resistance.
Make sure that the diet has been studied extensively for safety — and discuss any changes with your physician or registered dietitian before beginning a new diet. (If you don’t have a dietitian, find one in your area at the Academy of Nutrition and Dietetics website.) And do a self-check to ensure the diet fits with your own values and preferences.
Also, to the author I do appreciate you stating you are bias up front, but I do get to indulge with some fruit/berries when I want. You dont give up everything forever but you learn to fit them into your macros. I have learned to make Keto ice cream and fat bombs if the urge comes along. I have learned to take keto friendly foods along to potlucks that everyone loves. Keto can be a way to follow forever but everyone has their own needs for their bodies. I am new to this but finding it easier and easier to remain keto
Also, if you listen to Dr Bernstein talk about his childhood (he is well into his 80’s), the “original” recommended diet was only ketogenic in the sense that it was high-carb and caused keto-acidosis, which he describes as almost killing him as a teenager. He still considers the ADA recommendations as ketogenic for this reason (you only have to listen to him a short time to hear him railing against the ADA).
Beans can help boost feelings of fullness and manage blood sugar levels, making them an excellent ally in your weight loss battle. In fact, a recent study published in The American Journal of Clinical Nutrition found eating one serving a day of beans, peas, chickpeas or lentils could contribute to modest weight loss. And if you need another reason to bulk up on beans, remember that the fiber and protein-rich legumes are other excellent sources of genistein—the same compound found in peanuts and lentils that aids weight loss.
"We recommend against 'dieting', which is invariably a short-term solution," Dr. Gonzalez-Campoy, tells EndocrineWeb, "and since weight loss may be accomplished by a reduction in calories by any means, a ketogenic diet that restricts carbs is simply shifting the calories away from foods that typically demand insulin as in both of these studies.1,2  
Great article! Sustainability is key and Keto diet is extremely restrictive compared to others. Many of the comments I see don’t understand the importance of many years of research before stating something has a “significant difference” than the recommendations that are already in place. Also, understanding the pro/carb/fat balance in each meal instead of focusing on just carbohydrates. We have practiced the same modified Mediterranean diet at my practice where someone can enjoy life, eat complex carbohydrates and years later they are still successful and hundreds of pounds have been lost for good 🙂 Thank you for the reminder (and the comparison of Adkins supported research).
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]
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.
Hi Stacey, I can’t give medical advice and definitely recommend following your doctor’s recommendations. You can ask him/her if low carb would be better suited for you. Also, you may want to double check with him/her if the kidney concern was related to high protein, because that is a common misconception about keto – it is not a high protein diet/lifestyle.
Oh Mike, I just cried when I read this. Jesus…you are right on so many different levels. For you, this sacrifice is a total game changer. It’s changing every aspect of your life and yes I am very happy you were brave enough to divulge the erectile dysfunction (ED) issue also. It’s one of the biggest (no pun intended lol) issues for teens and men and the reason they get on board quickly with getting back on track! Once they learn their high blood sugars are the actual cause of the ED, they are extremely relieved and happy to learn any way to lower their blood glucose levels!
Spinach is a great source of iron, which is a key component in red blood cells that fuel our muscles with oxygen for energy. But researchers in Sweden identified another way in which these greens might keep you charged: Compounds found in spinach actually increase the efficiency of our mitochondria, the energy-producing factories inside our cells. That means eating a cup of cooked spinach a day may give you more lasting power on the elliptical machine (or in your daily sprint to catch the bus).
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%.
A computer program such as KetoCalculator may be used to help generate recipes.[46] The meals often have four components: heavy whipping cream, a protein-rich food (typically meat), a fruit or vegetable and a fat such as butter, vegetable oil or mayonnaise. Only low-carbohydrate fruits and vegetables are allowed, which excludes bananas, potatoes, peas and corn. Suitable fruits are divided into two groups based on the amount of carbohydrate they contain, and vegetables are similarly divided into two groups. Foods within each of these four groups may be freely substituted to allow for variation without needing to recalculate portion sizes. For example, cooked broccoli, Brussels sprouts, cauliflower and green beans are all equivalent. Fresh, canned or frozen foods are equivalent, but raw and cooked vegetables differ, and processed foods are an additional complication. Parents are required to be precise when measuring food quantities on an electronic scale accurate to 1 g. The child must eat the whole meal and cannot have extra portions; any snacks must be incorporated into the meal plan. A small amount of MCT oil may be used to help with constipation or to increase ketosis.[36]
I picked up this book because I had heard in several places that the DASH diet was currently the diet most recommended by doctors. So far the books have been disappointing. This book basically lays out a low carb diet, low fat diet that I'm not sure is mainstream DASH or just the program used by this particular author. I can see where the diet would result in weight loss for someone eating the Standard American Diet (SAD) but I can't think that sugar-free jello and flavored yogurt and low-fat pr ...more

Taub-Dix suggests slowing down and listening to your stomach, not your brain. “Believe it or not, your stomach is about the size of two of your fists. When you eat some bread and butter, a glass of wine, an appetizer, a main dish, and dessert and cappuccino—your mouth and mind will feel satisfied, but your stomach might have wanted to go home halfway through your meal!”
Lele Jaro has been on a ketogenic diet for over two years to help with her type 2 diabetes, and has successfully got off insulin. She’s been documenting her health journey on Instagram with keto-friendly food ideas, keto tips, and workout motivation. She’s lost over 80 pounds on her journey, and inspires others to try keto to improve their health. Connect with her on her YouTube channel or Facebook.
If you want to give the DASH diet a try, you're in luck: It works for everyone, according to Gorin. And since it involves eating the healthiest foods around and limiting the bad stuff, there aren't any cons. Plus, sticking to it won't just help you lose weight, it will also help keep your "heart health, blood pressure levels, and cholesterol levels" in check.
The good news here is no! All the evidence points to the fact that a low carbohydrate diet actually does lower blood glucose and A1c levels and does contribute to weight loss. The problem is we do not yet have enough large studies, over enough sustained years to support evidence that people with diabetes can remain on a highly restrictive Ketogenic Diet for the rest of their life and also not have other consequences to their health.
Have rest of frittata from Wednesday's breakfast. Serve with 2 cups baby spinach leaves, topped with 2 tablespoons balsamic vinegar, and 1 cup fat-free milk. Have one slice of whole-wheat toast topped with 2 teaspoons light trans-fat-free margarine. For dessert, have one 2-inch-square piece of baklava, a traditional Greek pastry with flaky fillo dough and walnuts. Athens Brand Frozen Baklava Pastry is available in many groceries nationwide. It's a great choice because the portions are tiny, and no baking or heating is required. (Have two squares if choosing Athens brand.)
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.
There’s been no poultry or red meat so far in the menu, so plan for two dinners a week incorporating these animal foods instead of fish. Eat with family or friends, whenever possible, and listen to music instead of watching TV. Enjoy a glass of red wine with your meal; a moderate intake gives you polyphenols -- natural compounds in grapes -- that may protect you from heart disease, cognitive problems and even cancer.

WH Verdict: Not all lectins are created equal and research into their impact on the body is ongoing. In fact, to date, there are no human studies linking the dietary lectins with a harmful immune response in healthy people. A lectin-free diet is also incredibly restrictive, with the list of foods you can’t eat reading like a typical shopping list for your average nutrition-conscious foodie, making it unsustainable and putting you at risk of nutritional deficiencies.
Enter the DASH diet. When individuals followed this eating plan, researchers saw dramatic reductions in blood pressure levels. Today, the eating plan is recommended for preventing and treating hypertension and heart disease—and it has been linked to decreased bone deterioration, improved insulin sensitivity, and possible risk reduction for some cancers.

Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.


Meanwhile, more than 70 trials have examined the health effects of a low-carb diet. They attest to the benefits64 associated with ketosis and low-carb diets, including a reduction in body weight and body mass index, improved cardiovascular risk factors including blood pressure, and the reversal of Type 2 diabetes. It is virtually impossible to imagine that a diet with so many health improvements in the ‘near term’ (2 years) could ultimately shorten life—and the study authors offer no possible mechanism to explain how this might happen.

Anna Taylor, RD, CDE, a licensed dietitian at the Cleveland Clinic in Ohio, says very-low-carb diets can hurt people with type 2 diabetes if done incorrectly. She and Keratsky say it’s important that anyone with diabetes who wants to try a low-carb or ultra-low-carb diet meet with a dietitian or physician to create a plan and make sure their eating style won’t react negatively with their current medicines.


It's important to note that the drop-out rate was substantial and reports of symptomatic hypoglycemia 1-5 episodes) were experienced by 69% of those in the study. The mean carbohydrate intake was 35 grams (+/- 15) daily. Based on self-reported results, the change in HbA1c was -1.45% (+/- 1.04, P < 0.001) with an average HbA1c of 7.2%  associated with greater hypoglycemia; yet, these results are comparable to other study findings. The average blood glucose levels were 104 mg/dL (+/- 16). 2  Final lipid profiles were mixed. The results were similar for adults and children.

Roussell recommends closely tracking your progress, so you don’t lose motivation. "If you track progress in a detailed way, you'll notice change happening. Measure data points like your chest, waist, arm size, and body-fat percentage with a tape measure—it’s possible that you can stay the same weight, but lose inches off your waist and other areas as your body tones and tightens,” he explains. “Don’t expect to lose two pounds per week every single week until you reach your goal."
Ketones are frequently produced in healthy individuals–sometimes this is due to fasting (even just overnight), or as a result of eating a very low carbohydrate diet. With normal blood glucose levels, the ketone concentrations observed during ketosis are generally not harmful. The ketones are simply a byproduct of fatty acid metabolism, serving up an alternative energy source when glucose stores are low.
The most effective diet for healthy weight loss just got better! THE DASH DIET WEIGHT LOSS SOLUTION turbocharges the DASH diet, ranked as the "Best Overall Diet" by US News & World Reports for 8 years in a row, with proven NIH research on DASH (Dietary Approaches to Stop Hypertension) to create a program guaranteed to speed weight loss and boost metabolism.
Alison Moodie is a health reporter based in Los Angeles. She has written for numerous outlets including Newsweek, Agence France-Presse, The Daily Mail and HuffPost. For years she covered sustainable business for The Guardian. She holds a master’s degree from Columbia University’s Graduate School of Journalism, where she majored in TV news. When she's not working she's doting on her two kids and whipping up Bulletproof-inspired dishes in her kitchen.
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