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]
It is completely wrong to discuss “average lifespan”. The average lifespans of pre-industrial peoples is heavily reduced by infant and early childhood mortality, which has nothing to do with lack of fresh fruit. Once you remove this bias in the numbers, pre-industrials can have lifespans almost as long as ours. And usually without many of the degenerative diseases that bother our middle and old ages.

If you’re on the ketogenic diet, be sure to test blood sugar levels throughout the day to make sure they are within their target range. Also, consider testing ketone levels to make sure you’re not at risk for DKA. The American Diabetes Association recommends testing for ketones if your blood sugar is higher than 240 mg/dL. You can test at home with urine strips.
If Doctor’s recommend Keto to their patients that less drugs and no kick back from pharmaceutical companies, they need to keep people medicated because pharmaceuticals run this entire country. I followed a strict diabetic diet when my husband was diagnosed with Type 2 NEVER could keep his blood sugars under control still would be 220 after a meal.. Keto has brought that down to 95-98 AFTER a meal.
You still have to cap alcohol. The hallmark of a Mediterranean diet is that drinking red wine socially is thought to be one reason why the diet is so healthy. But women should still stick to one glass, and men two glasses. If you have a history of breast cancer in the family, know that any alcohol consumption raises that risk. (31) In that case, talk to your doctor to find out what’s right for you.
You would be surprised how many people do read the comments. I wouldn’t say the article is crap. You are excited about keto because you have heard about it yesterday, or last week, or last month or last year or 2 years ago or 5 years ago or may be you were born in 20’s-30’s when it all started but I doubt you were born in 20’s-30’s because your language would differ a lot.
I do know a little bit about nutrition (what heavy person doesn't?). I wanted a plan that followed sound nutritional guidelines and had some research to back it up. This one does. Marla does a great job of explaining why the things I learned about nutrition in my 20s aren't working for me in my 40s, and then lays out, clearly, concisely, and with menus and recipes, what *will* work...and it did. I was nervous about cutting down on grains--I attempted the Atkins plan a few times and it just made me sick--but I felt fine. The menu plans are satisfying and tasty, and Marla has really helped me to re-frame the way I think about food.

One aspect that is not often mentioned is carb cravings. Before I started a keto diet, every day I would have serious starchy- or sweet- carb cravings that were uncontrollable and HAD TO BE satisfied. The high-fat keto diet has pretty much eliminated those carb cravings. It is wonderful to not be under the control of those cravings anymore. I think the high success rate of keto diets is that you are not hungry and have no cravings.
This book has helped me tremendously! My doctor recommended the Dash Diet for my high blood pressure. I have to say, it was not easy to break my addiction to sugar. Phase one (2 weeks) is painful. I failed a few times before finally breaking through and sticking with it. I had SO much success on phase one, I was afraid to move on and reintroduce fruit and whole grains to my diet so I remained on it for another 2 weeks. In one month of following the diet closely I lost almost 20 pounds. My blood pressure dropped so dramatically that my medication had to be significantly decreased. I did not do the exercise as recommended in the book due to very low energy levels, but imagine that if I had, I would have lost more weight. I highly recommend this book to anyone who has high blood pressure or cholesterol and wants to lose weight.

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.

Here’s what we do know: The keto diet may be useful in treating symptoms of epilepsy, a seizure disorder. “The use of keto in treating epilepsy has the most evidence,” Angelone says. One study conducted by Johns Hopkins Medicine, for example, followed epileptic patients on the keto diet and found that 36 percent of them had a 50 percent reduction in seizures after three months on the diet, and 16 percent were seizure-free. However, experts aren't entirely sure why the keto diet has this affect, she adds.


In a bowl, combine 7 1/2 ounces (half a 15-ounce can) canned chickpeas (rinse in a colander for two minutes to remove excess sodium and drain well; save other half for Tuesday's snack), 2 teaspoons olive oil, 1/4 cup chopped white onion, 1/4 cup chopped green pepper (save the rest of the onion and pepper for dinner), 1 tablespoon sliced black olives, 1/4 teaspoon ground black pepper, and 1 1/2 tablespoons white vinegar. Mix thoroughly. Serve mixture over 2 cups romaine lettuce leaves.
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)

My pick for the healthiest meal plan for diabetes? My favorite is the Mediterranean Diet. It’s high in fiber, low in saturated fats and includes no processed foods which is the challenge for all of us at this point in history. If we could all eat like they do in Italy and Greece! Think of Sicily and the coasts of Greece where their diet consists of fresh fish, fresh fruits and vegetables, nuts, beans, seeds, olives and olive oil, lean meats such as chicken and pork, some eggs and little red meat. The American Heart Association recommends it as well as the American Diabetes Association as being one healthy diet choice for people with diabetes.
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Short-term results for the LGIT indicate that at one month approximately half of the patients experience a greater than 50% reduction in seizure frequency, with overall figures approaching that of the ketogenic diet. The data (coming from one centre's experience with 76 children up to the year 2009) also indicate fewer side effects than the ketogenic diet and that it is better tolerated, with more palatable meals.[3][49]
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.)
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]
The trick here is not only to avoid all obvious sources of carbohydrate (sweets, bread, spaghetti, rice, potatoes), but also to be careful with your protein intake. If you eat large amounts of meat, eggs and the like, the excess protein will be converted into glucose in your body. Large amounts of protein can also raise your insulin levels somewhat. This compromises optimal ketosis.
Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:
Ketogenic diet (“keto” diet for short) is a catch-all term for any diet that pushes your body into the natural metabolic state of ketosis, which means burning fat for fuel instead of carbohydrates. Though there’s no set formula for keto, generally, the diet works by cutting back on carbohydrates, to about 20 g of net carbs to start, and replacing those with mostly fat and a moderate amount of protein, according to the popular website Keto Connect. Net carbs are the total number of carbs minus the fiber and sugar alcohols, according to the Atkins website. (More on this diet later.)

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.
About 20% of children on the ketogenic diet achieve freedom from seizures, and many are able to reduce the use of anticonvulsant drugs or eliminate them altogether.[3] Commonly, at around two years on the diet, or after six months of being seizure-free, the diet may be gradually discontinued over two or three months. This is done by lowering the ketogenic ratio until urinary ketosis is no longer detected, and then lifting all calorie restrictions.[45] This timing and method of discontinuation mimics that of anticonvulsant drug therapy in children, where the child has become seizure free. When the diet is required to treat certain metabolic diseases, the duration will be longer. The total diet duration is up to the treating ketogenic diet team and parents; durations up to 12 years have been studied and found beneficial.[9]

Because the diet isn’t as restrictive as a traditional vegan or vegetarian diet, it may be simpler to stick with — hence its No. 2 ranking in U.S. News & World Report’s Easiest Diets to Follow category. Because you’ll be eating meat some of the time, you may also be at a lower risk of the aforementioned nutrient deficiencies that vegetarians and vegans may face.


The scale is not necessarily your friend. You may want to lose fat – but the scale measures muscles, bone and internal organs as well. Gaining muscle is a good thing. Thus weight or BMI are imperfect ways to measure your progress. This is especially true if you’re just coming off a long period of semi-starvation (calorie counting), as your body may want to restore lost muscles etc. Starting weight training and gaining muscle can also hide your fat loss.
The DASH diet is an acronym for Dietary Approaches to Stop Hypertension. As you can probably guess, this eating plan was originally developed to help people lower their blood pressure. But it can do a whole lot more than that: The DASH diet has been shown to reduce bad cholesterol and improve insulin sensitivity. Studies have also suggested that following a DASH diet plan can reduce the risk of serious health issues such as stroke, kidney stones, and diabetes. It's no wonder why so many doctors recommend the DASH diet to their patients and why the plan has been ranked as the "best overall diet" by US News & World Reports for eight years in a row.
This diet plan will be especially important for people with metabolic syndrome, prediabetes, or diabetes. Post menopausal women will find that this plans helps them lose that extra midlife weight that is so troublesome. It will reduce your body's demand for insulin, and reduce the tendency to deposit fat in your midsection. Yes, that's right - this plan will reduce your waist size, which is an important indicator of health risks.
Blood specimens were obtained at weeks 0, 8, and 16 after the participant had fasted overnight. The following serum tests were performed in the hospital laboratory using standardized methods: complete blood count, chemistry panel, lipid panel, thyroid-stimulating hormone, and uric acid. A non-fasting specimen was also drawn at weeks 4 and 12 to monitor electrolytes and kidney function.
I think what bothered me most about the article was the way in which the writer has put her own fears about living without cake onto the shoulders of any diabetic she might treat. In the same way an epileptic might choose a life without cake in order to remain seizure free I choose a life without cake to remain “undiabetic”. I must admit that when I was researching this diet I did worry that I would not have the stamina, but the thought of going blind is a useful motivator.
The MIND diet, or Mediterranean-DASH Intervention for Neurodegenerative Delay, is a sort of hybrid between the DASH diet and the Mediterranean diet. It features foods meant to slow the progression or development of Alzheimer’s disease, the most common form of dementia and an incurable neurodegenerative condition that more than 5 million Americans are living with, according to the Alzheimer’s Association. (12) Some research backs up this notion, including a study published in September 2016 in Alzheimer’s Dementia that found a link between following the MIND Diet and a reduced risk of the disease. (13)
After 32 weeks, those in the keto diet group lowered their HbA1c more than those in the plate group with more than 50% achieving a reduction to less than 6.5%, basically reversing their diabetes. None in the plate group did this well. As for weight loss, those in the keto low-carb group lost on average of 28 pounds, while those in the plate group lost an average of 6.6 pounds.1
The DASH diet is especially recommended for people with hypertension (high blood pressure) or prehypertension. The DASH diet eating plan has been proven to lower blood pressure in studies sponsored by the National Institutes of Health (Dietary Approaches to Stop Hypertension). In addition to being a low salt (or low sodium) plan, the DASH diet provides additional benefits to reduce blood pressure. It is based on an eating plan rich in fruits and vegetables, and low-fat or non-fat dairy, with whole grains. It is a high fiber, low to moderate fat diet, rich in potasium, calcium, and magnesium. The full DASH diet plan is shown here. The DASH diet is a healthy plan, designed for the whole family. New research continues to show additional health benefits of the plan.
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.
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."
Your body needs a certain amount of essential vitamins and minerals to function properly. What happens when you don’t get enough of them? What happens when you eat too little food, or when the food you eat isn’t sufficiently nutritious? Perhaps our bodies catch on and reply by increasing hunger levels. After all – if we eat more, we increase the chances of consuming enough of whatever nutrient we are lacking.

I have T2D and IBS and my blood sugar readings were degrading. I was going to have to take a second daily dose of Metformin and the first one already played havoc with the IBS. I started a low-carb diet because my T1D husband had been inspired by a podcast by Sam Harris with scientist Gary Taubes, author Why We Get Fat, Good Calories, Bad Calories and the Case Against Sugar, and started dumping the majority of his carbs a month previous. He had cut his insulin use literally in half and lost 15 pounds. He was feeling better and visibly had more energy. I was resistant to the diet and even the idea of it. I have been on Atkins and Sugar Busters and while I did fine on Sugar Busters back in the day, Atkins was too fat-based and that was the opposite of how I had been raised to think about dieting. I knew that the Diabetic diet given to me by the Diabetic Educator had never been enough and I get carby binge cravings even though it offers plenty of carbs and calories. I also knew that it’s a cycle for me-eat more carbs, want more carbs, and never really feel satisfied. On top of that, when my stomach hurts I seek carbs, and it hurts quite often. I did Weight Watchers and the Diabetic diets because they let me “cheat” and have my carbs while dieting. To be fair, just the act of tracking my food improved my outcome on either. But I got mad at WW when they upped the points for carbs on their system and made it so I couldn’t eat cake for lunch if I wanted to. Not that I made a practice of it, but it was principle of the thing. Long story short, I was pretty doubtful that I would be very successful on Atkins or Keto. To humor my husband I began a low-carb diet that started out as Atkins 20 or Keto and has morphed to more of an Atkins 30-40 for my personal comfort while using Keto, Atkins, and Paleo recipes and ultimately cutting all gluten. That means 30-40 net carbs per day, rather than per meal and a lot of natural non-processed foods. The first week was quite terrible. But even through the Keto Flu I recognized that my IBS symptoms felt better. I started to suspect that if I felt that bad just from quitting carbs that maybe there was more to the idea of sugar addiction than I wanted to believe. I’m six weeks in now and I’m losing a steady pound a week plus my sugars have dropped radically. A pound a week might not sound like much but it’s more than I’ve lost in 10 years. I have PCOS and insulin resistance so I’ve had a fasting blood sugar that ranged from 109-113 since my early twenties. It was flying high around 160-170 before the diet, now I’m reading between 119-139. Even more than that, my IBS symptoms stabilized. I’ve been tracking all my food using the free Atkins meal tracker so I started trying to narrow the foods that caused flare ups. I’m lactose intolerant but I knew that and used lactose free products or Lactaid for the cream based dishes. I had my gall bladder removed and so have always put down my symptoms to an inability to process dairy and fats. Big surprise to find that a higher fat, higher dairy diet was making my symptoms disappear. Gluten is the only common factor so far. Celiac? Just a food sensitivity? I don’t know, but that will be the next investigation. It is an investigation that I would never have thought to start on the Diabetic diet. Like the author, I’m very fond of cake and carbs. Luckily there are low-carb, no-gluten recipes for muffins and cakes. They aren’t exactly the same and some are definitely better than others, but they are out there. Plus, there is nothing wrong with having true birthday cake once a year if that is really what you need and if you don’t have a reason to avoid it, like binge symptoms or IBS flare ups. My husband let himself have a piece of cheesecake the other day and felt physically awful for two day after, plus he had to use a lot of insulin to counter the spike. It’s a pretty good deterrent. Just a side note but I had other symptoms of inflammation as well. My ankles were swelling to golf ball size and painful, it was difficult for me to stand and walk comfortably when this happened. While they haven’t stopped completely, the discomfort has gone way down as has the swelling and frequency. What’s my point? I’m not a salesman for a particular diet. Everyone is different and some people might respond very well to Keto and/or Atkins while others may not need anything that extreme. I’m not knocking the Diabetic diet. My dad lost 150 pounds 38 years ago on a very low calorie/low carb Diabetic diet that gradually increased and he has kept the weight off all this time and kept his blood sugar steady with medication, but has not had to go to insulin even at age 84. Also, he was a smoker, a diabetic, had hemochromatosis and was over 300 pounds with an apple body shape. He has had some fall out from this-he didn’t stop the smoking until a heart attack 20 years ago and that didn’t help. But he has made it to 84 and when he walked into his doctor’s office 40 years ago I’m guessing the doctor wouldn’t have put any money on that survival rate. Unfortunately, it looks like I need the lower carb version and will continue to need it to manage my symptoms. I didn’t want it, that’s for sure. But Diabetics are locked in a death struggle with Diabetes and it won’t give up just because we are tired or want our sugar. So for me, it has to be Very Low Carb for Life. Others may find they need this too and discouraging them from trying it is not doing them any favors. Hopefully I will continue to find this sustainable. I just need to keep reminding myself that I am more fond of my feet and my vision than my birthday cake.


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]
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.)
The trick here is not only to avoid all obvious sources of carbohydrate (sweets, bread, spaghetti, rice, potatoes), but also to be careful with your protein intake. If you eat large amounts of meat, eggs and the like, the excess protein will be converted into glucose in your body. Large amounts of protein can also raise your insulin levels somewhat. This compromises optimal ketosis.
He also told me that I was in horrible shape, that I would need a lot of medication, and that because I was T2, insulin would do nothing for me. I still remember walking out of the building after. I felt like shooting myself. My brother had just gone blind from retinopathy 2 months earlier. There was no hope for me. High numbers were inevitable. Complications were inevitable.
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 emphasizes weight loss through fat-burning. The goal is to quickly lose weight and ultimately feel fuller with fewer cravings, while boosting your mood, mental focus and energy. According to Keto proponents, by slashing the carbs you consume and instead filling up on fats, you safely enter a state of ketosis. That’s when the body breaks down both dietary and stored body fat into substances called ketones. Your fat-burning system now relies mainly on fat – instead of sugar – for energy. While similar in some ways to familiar low-carb diets, the Keto diet’s extreme carb restrictions – about 20 net carbs a day or less, depending on the version – and the deliberate shift into ketosis are what set this increasingly popular diet apart.
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