There are theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child's meal. In many countries, food labelling is not mandatory so calculating the proportions of fat, protein and carbohydrate is difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.[53]
This was simply the best response to this article. The doctor who wrote it has no idea of the life changing benefits of keto. Bravo to you for speaking up. Congratulations on reversing your diabetes. I dont have diabetes and am not obese but I switched to keto to live a longer healthier life. I’ve never felt better. Must mention that I am 32. I want to prevent disease. Let the food be the medicine.

Prior to the advent of exogenous insulin for the treatment of diabetes mellitus in the 1920's, the mainstay of therapy was dietary modification. Diet recommendations in that era were aimed at controlling glycemia (actually, glycosuria) and were dramatically different from current low-fat, high-carbohydrate dietary recommendations for patients with diabetes [1,2]. For example, the Dr. Elliot Joslin Diabetic Diet in 1923 consisted of "meats, poultry, game, fish, clear soups, gelatin, eggs, butter, olive oil, coffee, tea" and contained approximately 5% of energy from carbohydrates, 20% from protein, and 75% from fat [3]. A similar diet was advocated by Dr. Frederick Allen of the same era [4].


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]


In conclusion, these three meta-analyses indicate that low-carb isn’t a “miracle diet,” but it may be one of the best, if not the best diet, for the management of type 2 diabetes and reversal of the condition in some cases. When people with type 2 diabetes follow a low-carbohydrate ketogenic diet, their health improves, weight is lost, blood sugar and HbA1c levels drop, and other health parameters improve significantly. Even studies that put healthy individuals on a ketogenic diet found similar improvements.

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.


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.

Twenty-one of the 28 participants who were enrolled completed the study. Twenty participants were men; 13 were White, 8 were African-American. The mean [± SD] age was 56.0 ± 7.9 years and BMI was 42.2 ± 5.8 kg/m2. Hemoglobin A1c decreased by 16% from 7.5 ± 1.4% to 6.3 ± 1.0% (p < 0.001) from baseline to week 16. Diabetes medications were discontinued in 7 participants, reduced in 10 participants, and unchanged in 4 participants. The mean body weight decreased by 6.6% from 131.4 ± 18.3 kg to 122.7 ± 18.9 kg (p < 0.001). In linear regression analyses, weight change at 16 weeks did not predict change in hemoglobin A1c. Fasting serum triglyceride decreased 42% from 2.69 ± 2.87 mmol/L to 1.57 ± 1.38 mmol/L (p = 0.001) while other serum lipid measurements did not change significantly.

There are three instances where there’s research to back up a ketogenic diet, including to help control type 2 diabetes, as part of epilepsy treatment, or for weight loss, says Mattinson. “In terms of diabetes, there is some promising research showing that the ketogenic diet may improve glycemic control. It may cause a reduction in A1C — a key test for diabetes that measures a person’s average blood sugar control over two to three months — something that may help you reduce medication use,” she says.


Frederick F. Samaha, M.D., Nayyar Iqbal, M.D., Prakash Seshadri, M.D., Kathryn L. Chicano, C.R.N.P., Denise A. Daily, R.D., Joyce McGrory, C.R.N.P., Terrence Williams, B.S., Monica Williams, B.S., Edward J. Gracely, Ph.D., and Linda Stern, M.D., “A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity,” N Engl J Med 2003; 348:2074-2081. http://www.nejm.org/doi/full/10.1056/NEJMoa022637.

Meat – like grass-fed selections – and fresh veggies are more expensive than most processed or fast foods. What you spend on Keto-friendly foods will vary with your choices of protein source and quality. You can select less-expensive, leaner cuts of meat and fatten them up with some oil. Buying less-exotic, in-season veggies will help keep you within budget.
“I’m no longer on insulin, and I have cut down my medications due to keto. I never had to deal with trying to find a spot to inject or having to deal with bruises on my belly,” she says. “I know this may sound silly, but I have a picture of my old insulin syringes in my wallet. I look at it to remind me of what I had to do before keto. It grounds me, and when I have days of self-doubt, I remind myself how far I’ve come.”
The ketogenic diet is not a benign, holistic or natural treatment for epilepsy; as with any serious medical therapy, there may be complications.[27] These are generally less severe and less frequent than with anticonvulsant medication or surgery.[27] Common but easily treatable short-term side effects include constipation, low-grade acidosis and hypoglycaemia if there is an initial fast. Raised levels of lipids in the blood affect up to 60% of children[37] and cholesterol levels may increase by around 30%.[27] This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and, if persistent, by lowering the ketogenic ratio.[37] Supplements are necessary to counter the dietary deficiency of many micronutrients.[3]
This high-fat, adequate-protein, low-carb fad diet sends the body into a state of ketosis, in which the body uses stored fat for energy. Research published in Clinical Cardiology suggests the ketogenic, or “keto,” diet can be an effective weight loss method, but to be successful, you must follow the plan consistently with no cheat days — otherwise, you’re just eating a high-fat diet that may be high in unhealthy fats for no reason. (1) (A pro tip? If you're planning on doing the diet, consider perusing this complete keto food list and reading up on the healthiest fats for keto diet followers.)
Those issues can be part of what's known as the “keto flu,” Warren says. Other side effects of the keto diet, all of which are tied to carb withdrawal, can include lightheadedness, nausea, mental fog, cramps, and headaches, in addition to tiredness. Luckily, the keto flu doesn't usually last more than a week—which is coincidentally about when people start to see the number on the scale go down, says Warren.
Burns fat: You can drop a lot of weight — and quickly — on the keto diet.[3] Ketones suppress ghrelin — your hunger hormone — and increase cholecystokinin (CCK), which makes you feel full.[4] Reduced appetite means it’s easier to go for longer periods without eating, which encourages your body to dip into its fat stores for energy. Learn more here about the keto diet and weight loss. 

From celebrity-endorsed to science-backed, finding the best diet for your body and lifestyle can be an exercise in frustration—definitely not the kind of exercise you need right now! To make your search easier, we've pulled together the 10 most popular diets based on which ones have consistently ranked highest on the annual U.S. News & World Report rankings, WebMD, and other current diet lists. Just know this: It's not about finding out which diet is the most popular overall but which one fits your goals and lifestyle the best. After all, the best diet for you is the one you can stick with (and enjoy)!
It sounds as if you may have been following a very strict keto protocol. I’m not, and have not followed a ketogenic diet, but am interested in it. I’ve been reading up on it a bit on the blog called Mark’s Daily Apple.* I’ve been following it for several years now, even before Mark tried keto. Based on some of his blog post, both keto related and otherwise, it seems that women do better with slightly more carbs than men. He’s written several blog post specifically for women, including one called 7 Keto Tips for Women, which you may want to read. https://www.marksdailyapple.com/7-keto-tips-for-women/ Then there is this one Where I Part Ways with the Popular Keto Movement https://www.marksdailyapple.com/where-i-part-ways-with-the-popular-keto-movement/ Perhaps the problem wasn’t the keto diet in and of itself, but that you went too low carb for you. It’s worth considering. I’ve also found this site to be pretty interesting https://peterattiamd.com/ Here’s a link to his section on keto https://peterattiamd.com/category/ketosis/ He followed a ketogenic diet for a number of years, though as of 2016 was no longer ketogenic, but definitely eating lower carb than most. (That is under Articles, on the drop down menu, click on Personal.)
“Intermittent fasting can be really challenging if you have an ever-changing schedule,” adds Hultin. “If you're traveling and crossing time zones, it could be very difficult to follow. It might be best for people with more stability in their lives.” Intermittent fasting isn’t safe for people with type 2 diabetes, children, pregnant or lactating women, or anyone with a history of an eating disorder.
Many equate healthy eating, particularly lower-sodium eating such as DASH, with the idea that all meals have to be cooked from scratch. This is overwhelming for many (myself included), but there are plenty of tricks and tips to help you. First, understand that “whole foods” doesn’t exclusively mean fresh produce. Take advantage of time-saving, minimally processed foods like unseasoned frozen vegetables and no-salt-added canned veggies.
Pros: Compared to eating a traditional diet, switching to a low-carb diet can significantly reduce body fat, studies show. Cap your carb intake at 20% of daily calories and the weight-loss results are even stronger—plus, you can reduce your risk for heart disease and stroke. Some research suggests low-carb diets are even better than low-fat diets: One study in Annals of Internal Medicine found that people who limited their carbs lost eight more pounds than those who cut back on fat. If you cut back on carbs enough, your body learns to burn fat as fuel instead. Studies are mixed on how low-carb diets affect performance, but some evidence suggests that endurance performance can actually improve among people whose bodies adapt to fat-burning fairly easily.
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
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)
One review, published in April 2016 in The American Journal of Medicine, looked at five research trials on overweight and obese people and found that after one year those who followed a Mediterranean diet lost as much as 11 pounds (lbs) more than low-fat eaters. (6) (They lost between 9 and 22 lbs total and kept it off for a year.) But that same study found similar weight loss in other diets, like low-carb diets and the American Diabetes Association diet. The results suggest, the researchers say, that “there is no ideal diet for achieving sustained weight loss in overweight or obese individuals.”
Financial disclosures: There were no conflicts of interest reported except for Dr Bernstein who has received royalties for books on the management of diabetes (which were used by members of the online social media group surveyed in this study). Dr. Hallberg who holds stock options and receives research support from Virta Health, and consulting fees from Atkins. Dr. Rhodes is the site principal investigator in clinical trials for pediatric type 2 diabetes that are sponsored by Merck and AstraZeneca. Dr. Westman has an ownership interest in companies using low-carbohydrate principles, and he receives royalties for books related to low-carbohydrate diets. Dr. Ludwig has received royalties from books on nutrition and obesity; and Dr. Galati is author of Eating Yourself Sick: How to stop obesity, fatty liver, and diabetes from killing you and your family (2018).
Bueno NB, de Melo ISV, de Oliveira SL, da Rocha Ataide T; “Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomized controlled trials” (2013) British Journal of Nutrition 110(7): 1178-1187. Accessed 4/23/2018 https://www.cambridge.org/core/services/aop-cambridge-core/content/view/6FD9F975BAFF1D46F84C8BA9CE860783/S0007114513000548a.pdf/verylowcarbohydrate_ketogenic_diet_v_lowfat_diet_for_longterm_weight_loss_a_metaanalysis_of_randomised_controlled_trials.pdf
"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  
There are many ways in which epilepsy occurs. Examples of pathological physiology include: unusual excitatory connections within the neuronal network of the brain; abnormal neuron structure leading to altered current flow; decreased inhibitory neurotransmitter synthesis; ineffective receptors for inhibitory neurotransmitters; insufficient breakdown of excitatory neurotransmitters leading to excess; immature synapse development; and impaired function of ionic channels.[7]
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.

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.


The struggle as a prescriber is that you have to follow the “standard of care,” lest you open yourself up to a lawsuit. So I talk to my patents about what “the” recommendations are, and then I talk to them bout what the evidence says and what my experience says. Plain and simple, patient’s trust the government’s recommendations and can’t wrap their head around the idea of not eating carbs because they have learned their entire lives that the body “needs” carbs to survive.
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).

A 2016 study in The Lancet Diabetes & Endocrinology journal that analyzed data from Predimed – a five-year trial including 7,447 adults with Type 2 diabetes or at risk for cardiovascular disease who were assigned either a Mediterranean diet supplemented with olive oil, the same diet supplemented with nuts or a control diet – found that people on the Mediterranean versions added the fewest inches to their waistlines. The olive oil folks lost the most weight.
Control portion size. Ideas for how to do this include downsizing your dishes, eating without watching TV or being otherwise distracted, and keeping unhealthy food out of sight. An important component of the DASH diet is also to eat smaller portions more frequently throughout the day. This is a way to reduce the risk of overeating and to distribute your energy evenly during the day.
I have multiple autoimmune diseases. I fought 4 doctors, all of whom told me that adults can’t get type 1. I finally went to the Jefferson Diabetes Center. Yup! Type 1 diabetes. I’m slender, do marathons, bp 100/60, triglyceride/HDL ratio 1.08. And I STILL fought 4 doctors because of the ADA misinformation. All it takes is a simple blood test to look at antibodies. That’s all it takes, but the test is almost never run.
Christian Wolfrum, one of the corresponding authors on the paper said 'Diabetes is one of the biggest health issues we face. Although ketogenic diets are known to be healthy, our findings indicate that there may be an increased risk of insulin resistance with this type of diet that may lead to Type 2 diabetes. The next step is to try to identify the mechanism for this effect and to address whether this is a physiological adaptation. Our hypothesis is that when fatty acids are metabolized, their products might have important signaling roles to play in the brain.'
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.
You'll find lots of free Mediterranean diet resources on the Oldways website, including an easy-to-understand food pyramid; a printable grocery list; gender- and age-specific tips on making the Mediterranean switch; a quick-read "starter" brochure; a recipe newsletter; and even a glossary defining Mediterranean staples, from bruschetta to tapenade.
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…)
The Mediterranean Diet is a great way for people who are used to doughnuts in the morning to start feeling the difference that eating real food makes. After a while though, you may hit a plateau with weight or maybe you know you’re capable of having more energy or a clearer mind. That’s where these extra little tweaks come in. With a few minor changes, you can adjust the Mediterranean Diet to help you perform at max power.
What the expert says: ‘There have been a number of cases where GPs have said, “You’ve got IBS, go on the low-FODMAP diet”,’ says Dr Megan Rossi (@theguthealthdoctor). ‘The only support they give you is a printout with a limited explanation of the diet from the internet. I’ve had clients come into my practice who’ve been given a list of 10 “friendly” foods to survive on, which is nutritionally dangerous.’
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.[10][14]
Benefits The main ingredient in hummus, chickpeas pack an impressive amount of fiber (more than half of a woman’s 25 g daily quota), as well as iron, zinc, folate, and magnesium, according to a paper published in November 2014 in the journal Applied Physiology, Nutrition, and Metabolism. (15,16) The stats above are for a whole cup, but you only need ½ cup per day to reap the benefits.
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.
DASH was first introduced at a meeting of the American Heart Association in 1996 and later published in the New England Journal of Medicine in 1997. [2] The DASH trial randomly assigned 456 people to different diets to test the effects of dietary patterns on lowering blood pressure. The authors surmised that eating a diet with many different foods with blood pressure-lowering nutrients would show a greater effect on blood pressure than eating single nutrients, such as found in supplements or in a limited diet. Three diets were tested: 1) a control diet, or a standard American diet, 2) a fruits and vegetables diet, similar to the control diet but providing more fruits and vegetables and less snacks and sweets, and 3) a combination diet rich in fruits, vegetables, nuts, and low-fat dairy foods with reduced amounts of saturated fat, total fat, and cholesterol. The last two diets were richer in nutrients associated with lower blood pressure, such as potassium, magnesium, calcium, fiber, and protein. All three diets provided about 3000 mg sodium, which is more than the recommended amount from the Dietary Guidelines for Americans but less than the average sodium intake for Americans. [3]

Benefits The main ingredient in hummus, chickpeas pack an impressive amount of fiber (more than half of a woman’s 25 g daily quota), as well as iron, zinc, folate, and magnesium, according to a paper published in November 2014 in the journal Applied Physiology, Nutrition, and Metabolism. (15,16) The stats above are for a whole cup, but you only need ½ cup per day to reap the benefits.
Yet it’s an incredibly well-rounded way to lose weight that ditches gimmicks and doesn’t require calorie or macronutrient counting as other diets do. And with the emphasis on healthy fat, it’s satisfying, too. That said, the 2019 U.S. News & World Report Best Diets ranked the Mediterranean diet as No. 1 for Best Diets Overall and it ranks 17 in their list of Best Weight-Loss Diets. (3) The reviewers note that it’s not a slam dunk, and all depends on how you eat. Even healthy diets like the Mediterranean aren’t free-for-all eating plans.
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!
In a second study,2 a Harvard-led research team evaluated the benefit of a ketogenic diet in both children and adults with type 1 diabetes despite concerns about a possible negative effect on growth and development in children following such a restricted diet. These researchers report "exceptional" glucose control with little adverse effects. However, the participants were recruited from a closed Facebook group, TypeOneGrit, for people who follow a diet and diabetes program based on the recommendations in the Diabetes Solution,3 a book by Richard K Bernstein, MD, who devised this program to manage his own type 1 diabetes.
In its 2016 report “Healthy Eating Guidelines & Weight Loss Advice,” the Public Health Collaboration, a U.K. nonprofit, evaluated evidence on low-carbohydrate, high-fat diets. (The Keto diet falls under the LCHF umbrella.) Among 53 randomized clinical trials comparing LCHF diets to calorie-counting, low-fat diets, a majority of studies showed greater weight loss for the Keto-type diets, along with more beneficial health outcomes. The collaboration recommends weight-loss guidelines that include a low-carbohydrate, high-fat diet of real (rather than processed) foods as an acceptable, effective and safe approach.
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