Carbohydrate Restriction. To help people with diabetes manage their blood sugar levels, doctors will typically prescribe a diet that mostly consists of low glycemic index foods. [23] However, according to the research, restricting overall carb intake to the point of following a keto diet may be the best way to improve the many biomarkers relevant to diabetes. [24] In fact, this dietary strategy has been proven to be helpful for the management of type 2 diabetes and type 1 diabetes.
The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]

In this single-arm, 4-month diet intervention, an LCKD resulted in significant improvement of glycemia, as measured by fasting glucose and hemoglobin A1c, in patients with type 2 diabetes. More importantly, this improvement was observed while diabetes medications were reduced or discontinued in 17 of the 21 participants, and were not changed in the remaining 4 participants. Participants also experienced reductions in body weight, waist circumference, and percent body fat but these improvements were moderate and did not predict the change in hemoglobin A1c in regression analyses.
Hi Cyn, The numbers are general guidelines but will vary depending on many factors, such as activity level, insulin resistance, weight and more. There is no single magic number, just conventional recommendations that are a good starting point. I will have a macro calculator coming soon that will help determine what is best for each person, but even then it’s an approximation. The only way to know for sure is to test. If keto is your goal, it’s usually best to start lower and then see if you can stay in ketosis when increasing.
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!
We are just two days into 2019, but already the best diet of the year has been named. US News and World Report listed the Mediterranean diet as the best overall diet for 2019 after evaluating 41 of the most popular diets. It was also named best diabetes diet, best diet for healthy eating, best plant-based diet, best heart-healthy diet, and easiest diet to follow.
Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?
I teach ADA. I saw 49 people in 8 months. All except 1 lost weight and had A1C reduction. 16 reversed their condition. All this on ADA diet. ADA works, you just have to follow it. Keto will work also, I just do not believe that it is healthy in the long term. We need more study results, and evidence that it works before we recommend that everyone should go on a keto diet. I would recommend that any of you who are on keto diet, and who are adamant that it works, and that ADA does not, should look for clinical trials and become subjects. We will need to know scientifically that it works, not just by word of mouth. And we will need to see medical evidence that it helps. If there is science behind it, I am sure that ADA will get behind it. Their are medical programs where you can be followed on a keto diet. Look for those.

We are just two days into 2019, but already the best diet of the year has been named. US News and World Report listed the Mediterranean diet as the best overall diet for 2019 after evaluating 41 of the most popular diets. It was also named best diabetes diet, best diet for healthy eating, best plant-based diet, best heart-healthy diet, and easiest diet to follow.

Cortisone as an oral drug is another common culprit (e.g. Prednisolone). Cortisone often causes weight gain in the long run, especially at higher doses (e.g. more than 5 mg Prednisolone per day). Unfortunately, cortisone is often an essential medication for those who are prescribed it, but the dose should be adjusted frequently so you don’t take more than you need. Asthma inhalers and other local cortisone treatments, like creams or nose sprays, hardly affect weight.


The basal metabolic rate per gram of body weight is seven times greater in mice than in humans. Organisms with large mass-specific metabolic rates typically show relatively large deviations from "normal" values because of a weak capacity to maintain homeostasis. Mice, which have a higher mass-specific metabolic rate, have a weak capacity to maintain cellular homeostasis; humans have a lower mass-specific metabolic rate, and a strong capacity to maintain cellular homeostasis. Mice are not small people, and "everyone else did it" is not a sound experimental design rationale.
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]

But again, when it comes to salt, there's a blood pressure-weight link that can't go ignored. A diet rich in sodium may lead to the development of obesity, according to one study, and salty foods are more likely to promote overeating, which obviously also leads to weight gain, per another study. And by now, it's more than evident that excess fat and sugar intake can contribute to caloric surpluses, blood sugar and insulin spikes, inflammation, and, yes, more weight gain, she says.
Coffee jumpstarts your metabolism, making the non-decaf stuff a worthy weight loss ally. According to a study published in the journal Physiology & Behavior, the average metabolic rate of people who drank caffeinated coffee was 16 percent higher than that of those who drank decaf. In addition to caffeinating your coffee, it’s also crucial to keep it black and avoid adding any unhealthy creamers and artificial sweeteners, both of which are enemies of weight loss.
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

Several comprehensive studies and meta-analyses have demonstrated that after a few months or even a year of a low carb diet versus a moderate/high carb diet, there are no significant differences in the amount of weight lost (2,3,4,5).  I will say, however, most of these diets are NOT keto and are simply lower carb (i.e. 20%).  Also, long-term effects (beyond 1 year) are not often studied due to budgetary constraints, so interpret results as you wish.
Cons: Eating this way perpetuates the outdated idea that dietary fat is the enemy of body fat. And it isn’t necessarily better than other diets: One study in the American Journal of Clinical Nutrition compared high-protein, normal protein, high-fat, and low-fat diets, and found no significant difference in fat loss among the groups at six months or two years (though all did result in some fat loss). What’s more, while the low-fat group was supposed to keep its intake of the macro at 20%, actual intake was closer to 26-28%, suggesting that sticking to a strict low-fat diet is rather difficult and potentially unrealistic for most.
The main limitations of our study are its small sample size, short duration, and lack of control group. That the main outcome, hemoglobin A1c, improved significantly despite the small sample size and short duration of follow-up speaks to the dramatic and consistent effect of the LCKD on glycemia. For other effects, however, such as the rises in serum LDL and HDL cholesterol, the small sample size might be the reason statistical significance was not reached. Future studies of larger samples and containing a control group are needed to better address questions about the effect of the LCKD on serum lipids in patients with type 2 diabetes.
A systematic review in 2016 found and analysed seven randomized controlled trials of ketogenic diet in children and young people with epilepsy.[2] The trials were done among children and young people for whom drugs failed to control their seizures, and only one of the trials compared a group assigned to ketogenic diet with a group not assigned to one.[16] The other trials compared types of diets or ways of introducing them to make them more tolerable.[2] Nearly 40% of the children and young people had half or fewer seizures with the diet compared with the group not assigned to the diet. Only about 10% were still on the diet after a few years.[2] Adverse effects such as hunger and loss of energy in that trial were common, with about 30% experiencing constipation.[16]
6. Longer life. A recent meta-analysis in the British Medical Journal found the diet significantly improved health and led to a 9 percent reduction in death from heart disease, cancer, Parkinson's, and Alzheimer's. Other studies have found that the diet's healthy fats may lessen the inflammation and pain of rheumatoid arthritis and cut the risk of getting amyotrophic lateral sclerosis (Lou Gehrig's disease) by 60 percent.
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.
Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions.[18] Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.[3]
High blood sugar levels coupled with high blood ketones, on the other hand, will mean that you have a pathologically low level of insulin – something non-diabetics do not suffer from. This can lead to ketoacidosis – a potentially life-threatening condition. If this happens, you’ll need to inject more insulin; if you’re at all unsure of what to do, contact a medical professional. Coveting really high blood ketones for weight control is not worth the risk for type 1 diabetics.
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.)
Results of meta-analysis of 12 large studies conducted between 1966 and 2008, covering more than 1.5 million subjects, were published in the British Journal of Nutrition in 2009. The authors concluded that the Mediterranean diet is associated with significant health benefits, including lower mortality overall, and reduced risk of chronic diseases like heart disease, cancer, Alzheimer’s and Parkinson’s.
The first meta-analysis worth noting collected the data from 10 randomized trials comprising 1376 participants in total. [14] After analyzing the research, a key relationship emerged between dietary carbs and blood sugar levels. In short, the researchers described their finding thus: “the greater the carbohydrate restriction, the greater glucose lowering…” [14]
I read the book while sitting by the pool that Sunday afternoon and informed my girlfriend that we were going to be starting a new diet on Monday. “Oh really,” she asked. “What is so good about this diet?” I told her about the salads, fresh fruit and vegetable dishes, and her favorite part, how we would be replacing steak night with chicken and much more fish. “This is the perfect diet for summer!”
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)
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]

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!
I’ve been doing low-carb-high-fat (LCHF) for more than nine years. I’m not diabetic and never was so far as I know, nor was I particularly overweight. I simply became convinced over time that this way of eating is the best way to limit the damage which can be done by a lifetime of exposure to the standard American high-carb, starchy, sugary diet. I love my fatty meat, egg yolks, butter, sour cream, and more. I suppose I am fortunate I never had “carb-cravings”.
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.

As Tammy points out, diets are diets, and many people nowadays think/feel that diets are a “time/value-based goal”. “If I just get my weight down, or if I just fix this, then I’ll be all set…” WRONG!!! There in lies the first problem. How long can it be maintained? Well that’s a good point. The real question is, how long is one committed to changing their life, and how strong is their desire to do it. ALL things that one wants to change in life, require a change in to the way their living and/or perceiving life. They require a life-style change. One could attempt a Mediterranean diet, and yet relapse back to “normal” eating after 3mos, 1yr, 3yrs, etc.. It doesn’t really matter if the change isn’t first on the mental and emotional level. Unfortunately, many first-world daily diets (namely American) incorporate many foods that are addictive which can cause cravings. And yes, the cravings are scientifically prove-able, and have been proved. We grow up thinking that it’s “normal” to have your cake (since its the carb of debate lol) and eat it too, because why?… Well because that’s how they were raised. Simply as that. Conditioned living if you will. There are many cultures on this planet that DO NOT grow up eating as many carbs and sweets as the American Diet, and do perfectly fine without all the sugars and carb cravings. And incidentally, they also lead healthier lives too… Go figure.


This is a wealth of information. My husband and I are starting the keto diet tomorrow and I knew nothing about it. When I sat down to look up information about it, I found this. Thank you! This is everything I need to know in one place. We are not as healthy as we’d like to be and I am optimistic this will help us obtain our goals, along with an exercise plan.
Hello everyone. I was diagnosed as a diabetic in 2010. I followed the ADA diet while taking metformin and lnsulin and could never get by glucose readings below 135. Most mornings it was at 175 or higher. In mid 2017 I had to find a new doctor. I ran out of meds in Semtember of that year but could not find a doctor due to not accepting new patients and or my health insurance. I broke my foot at work on the last workday in December. Was instructed to stay off foot for 6 to 9 months . In the mean time I finally got to see my new family practitioner on March 28 2018. Represcribed meds and ordered blood work. A1c was ar 14.1. With my new glucose meter my readings were 375. Due to basically being bedridden while my foot heals I was concerned about diabetic complications an weight gain as I was already overweight. After doing research online I learned about the keto diet. I began the diet on 3/29 /2018 along with intermittent fasting. I weighed 265#. As of 4/26/2008 I am at 245#. My glucose readings have been on average 73 to 98 and a couple of times 111. I stopped all my medication about a week ago just to see if they would increase. They have not so far and I check 4 times daily. I sleep better and do not crave sweets. I feel full . The first two weeks were tough but now I can go 2-3 days without being hungry. I am looking forward to the results of my next blood test in June. This diet fits my circumstances and I do plan on to exercise when I am able to. I want to reach my weight to height ratio also. When I achieve this goal I may tweak my diet at that time but for right now that is what is working for me. I may never be able to eat some of the things I used to but considering the complications of diabetes it is one hell of incentive for willpower to stay on the diet.I will repost again after my next blood test or if there are any significant changes.
Aude, Y., A. S, Agatston, F. Lopez-Jimenez, et al. “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat: A Randomized Trial.” JAMA Internal Medicine 164, no. 19 (2004): 2141–46. doi: 10.1001/archinte.164.19.2141. jamanetwork.com/journals/jamainternalmedicine/article-abstract/217514.

I think that the experts don’t want to admit that they have been wrong all this time, They all screamed low fat/high carb which is a miserable, unsatisfying way to eat. Who wants to eat a potato with plain yogurt? Gross! She mentions that you are missing out on vital nutrients, but where is the mention that you are giving up things your body needs when you limit fats too? Keto is the only way to eat where you feel satisfied. I would eat cereal and be starving an hour later. How is that helpful? I can eat bacon and eggs (no toast), and be perfectly content for hours. It takes more food preparation, but I truly believe now that bread (whole grain or not) is the enemy of man.
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.
The following weekend I was looking for a book on this diet at Barnes & Noble in Colonie Center. A title caught my eye, “The Mediterranean Diet Plan,” written by Susan Zogheib. After reading the book’s introduction I quickly skimmed through the background of the diet and stopped at the diet plans. I smiled. I thought to myself, “I could totally do this!” I skipped ahead to the recipes. At that moment I knew I had found my diet plan! The book has four, four-week diet plans complete with recipes for every meal that are structured on the level of comfort you have with making the switch. One month of meals AND recipes, I couldn’t wait!
Hello everyone. I was diagnosed as a diabetic in 2010. I followed the ADA diet while taking metformin and lnsulin and could never get by glucose readings below 135. Most mornings it was at 175 or higher. In mid 2017 I had to find a new doctor. I ran out of meds in Semtember of that year but could not find a doctor due to not accepting new patients and or my health insurance. I broke my foot at work on the last workday in December. Was instructed to stay off foot for 6 to 9 months . In the mean time I finally got to see my new family practitioner on March 28 2018. Represcribed meds and ordered blood work. A1c was ar 14.1. With my new glucose meter my readings were 375. Due to basically being bedridden while my foot heals I was concerned about diabetic complications an weight gain as I was already overweight. After doing research online I learned about the keto diet. I began the diet on 3/29 /2018 along with intermittent fasting. I weighed 265#. As of 4/26/2008 I am at 245#. My glucose readings have been on average 73 to 98 and a couple of times 111. I stopped all my medication about a week ago just to see if they would increase. They have not so far and I check 4 times daily. I sleep better and do not crave sweets. I feel full . The first two weeks were tough but now I can go 2-3 days without being hungry. I am looking forward to the results of my next blood test in June. This diet fits my circumstances and I do plan on to exercise when I am able to. I want to reach my weight to height ratio also. When I achieve this goal I may tweak my diet at that time but for right now that is what is working for me. I may never be able to eat some of the things I used to but considering the complications of diabetes it is one hell of incentive for willpower to stay on the diet.I will repost again after my next blood test or if there are any significant changes.
Spirulina is a high-protein seaweed supplement that’s typically dried and sold in powdered form. The dried stuff is about 60 percent protein, and, like quinoa, it’s a complete protein, meaning it can be converted directly into muscle in the body and is thus a great weight loss tool. A tablespoon of the blue-green algae delivers 8 grams of metabolism-boosting protein for just 43 calories, plus half a day’s allotment of vitamin B12, which in and of itself can give you more energy and boost your metabolism. Try tossing some spirulina into a smoothie and watching the pounds melt off. For more skinny smoothie ideas, check out this list of 56 Smoothies for Weight Loss!

On day 2, cook a cup of oatmeal with an ounce of chopped walnuts and 1/2 cup of sliced apples for a breakfast high in fiber and protein; sprinkle in a teaspoon of cinnamon and maple syrup. Have this breakfast again on day 5, but vary the add-ins -- try 1/2 cup of strawberries with thinly sliced almonds. If you like milk with your oatmeal, opt for unsweetened almond or soy.
While it’s true that low-carb diets do raise the so-called bad LDL-cholesterol in some people, it’s important to note that LDL-C, when influenced by diet, has never been shown to have any effect on cardiovascular risk. Large clinical trials and observational studies show that one’s level of LDL-C and the lowering of LDL-C through diet is not reliably linked to cardiovascular outcomes.21, 22, 23
7. I should mention ALL my health markers have DRASTICALLY improved including cholesterol and inflammation markers? My fatty liver is resolving and my cardio markers are perfect! The study where you cited there were not significant changed in diabetes markers in two months, well it takes longer! Check it out at 6 and 8 months. Most people will show a VERY different story than what you are reporting!

Keto breath, on the other hand, is less of a side-effect and more of a harmless inconvenience (your breath literally smells like nail polish remover). Basically, when your body breaks down all that extra fat on the keto diet, it produces ketones—one of which is the chemical acetone, Keatley previously told WomensHealthMag.com. (Yes, the same stuff that's in nail polish remover.)

Hello, I am hoping someone can reach out to me and explain something. My son who is T1D just started the keto diet 4 days ago. At first we were doing great numbers were good, then out of nowhere we are having highs! He is correcting and it’s not bringing him down into normal range. I am going into a panic, I don’t know what to do, or who to ask for help. His doctor would be no help, and thinks the Standard American Diet is fine. I don’t see eye to eye with him. I hope someone can tell me why this might be happening. Thanks in advance for your time!
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.
Emerging evidence suggests that eating this way may offer protective effects for those with and at risk for type 2 diabetes. For one, Mediterranean eating improves blood sugar control in those already diagnosed with the condition, suggesting it can be a good way to manage the disease. What’s more, given those with diabetes are at increased odds for cardiovascular disease, adopting this diet can help improve their heart health, according to a paper published in April 2014 in the journal Nutrients. (4)
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]
×