Y. Wady Aude, MD; Arthur S. Agatston, MD; Francisco Lopez-Jimenez, MD, MSc; Eric H. Lieberman, MD; Marie Almon, MS, RD; Melinda Hansen, ARNP; Gerardo Rojas, MD; Gervasio A. Lamas, MD; Charles H. Hennekens, MD, DrPH, “The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat,” Arch Intern Med. 2004;164(19):2141-2146. http://archinte.jamanetwork.com/article.aspx?articleid=217514.
Eating low-carb paleo means removing items like rice, pasta, and legumes from your diet completely, but the carbs you eat will be from vegetables like fruit, beets, sweet potatoes, and leafy greens, such as spinach and kale. The diet also cuts out processed food plus foods allowed on other low-carb diets, including milk and cheese, and some people have an easier time sticking with the diet when more carbs are included.
Both groups experienced no notable adverse effects in their health. In the 29 subjects who successfully completed the calorie-restricted diet, researchers observed an average 16% reduction in fasting glucose, 2.7 reduction in BMI, and loss of 6.9 kg of bodyweight. [9] However, in the 21 subjects that successfully completed the very-low carbohydrate ketogenic diet, subjects experienced an average 19.9% reduction in fasting glucose, 3.9 decrease in BMI, and loss of 11.1 kg of bodyweight. [9]
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.
Last night I cooked Mediterranean grilled chicken and dill yogurt, Greek potato wedges, Greek salad and pita all from your recipes (except the salad which i made from memory having spent 3 months in Greece many years ago). I reckon with every mouthful i exhaled a YUM, as did my guests. I like this way of cooking for its simplicity, wholesomeness and flavoursomeness. Hmmm I wonder what I’ll cook next. Thanks for all the choices.
In recent years, the ketogenic diet has been attracting a lot of attention for the management of numerous health conditions, as well as for weight loss. Some controversy still exists about its safety and efficacy, largely stemming from a lack of longitudinal and mechanistic studies, inconsistencies in diet composition in different cohorts, and disagreement in conclusions between research conducted on animal vs. human populations.
You are so biased against Keto, this can be noticed very quickly because almost every positive thing you say about Keto, you immediately follow with a “but…” negative statement. And most of your negatives are simply saying it’s hard to maintain. You completely exaggerate the negatives “If you have one bad day and your body is kicked out of Ketosis, you immediately gain all of your weight back”. That is simply not true; if someone is on a Keto diet for 3 months, they will not gain that weight back in a day. Also, their body will be back into Ketosis the next morning. You say that the ADA doesn’t recommend 60-70 grams per meal, but it does (coincidentally I just left their website before coming here). I don’t claim to be a Diabetes expert; I admit that. But your bias is leaning heavily against Keto. “Moderation” is not your goal if you have diabetes. When you compare HbA1C levels, for example, you compare them with someone in Keto at less than 20 g of Carbs per day as compared to someone at a 70-90 gram of carbs per day diet. You should be fair and compare them with someone on a 200 g of Carbs diet. If you want to get rid of the effects of Diabetes, get on a Keto Diet, period. It MAY get rid of the effects completely, but in the very least it WILL reduce your Insulin needs to very low and you’ll have little-to-no side effects other than a relatively restrictive diet (most diets are WAY more restrictive than Keto). You back up everything with “science” and misleading numbers/arguments without providing any real evidence.
Swanson, a professor of neurology who has researched the impacts of ketogenic diets on inflammation in the brain, got curious about the ketogenic diet when trying to treat the inflammation that persists for days after a person suffers a stroke. When he tried inducing a ketogenic state in mice with stroke injuries, he said, “I was overwhelmed by the effect.” Blocking glucose metabolism worked to suppress inflammatory genes, which in turn helped stroke healing.
While body weight decreased significantly (-8.5 kg) in these 21 diabetic participants, the mean weight loss was less compared with what we observed in the LCKD participants of an earlier trial (-12.0 kg) [18]. Given that the diabetic participants had a higher baseline mean weight than the LCKD participants of our previous trial (131 kg vs. 97 kg), this translates into an even more dramatic disparity in percent change in body weight (-6.6% vs. -12.9%). This lesser weight loss might result from several factors. First, in the current study, most of the participants were taking insulin and/or oral hypoglycemic agents that are known to induce weight gain[20,21] Second, these same agents, particularly insulin, inhibit ketosis, which is strived for in the earliest phases of the LCKD; while it remains unclear whether ketones actually play a role in weight loss on the LCKD, previous research in non-diabetic patients has shown a positive correlation between level of ketonuria and weight loss success [22]. Lastly, compared with our previous study the participants in the current study had more comorbid illness, lower socioeconomic status, and a shorter duration of follow-up (16 weeks versus 24 weeks), all of which are associated with reduced success on any weight loss program [23].
I do have a couple of questions. I’m not vegan, but is there room for tempeh (as an alternative)? I love yogurt but I also love cottage cheese – would that be allowed and what about green tea or organic matcha? Oh, one more question, after doing weight watchers, I became obsessed with weighing my food and watching my portion sizes. When I was an unhealthy eater that was my downfall. I’ve mainly been trying to eat clean for the last year, but I still weigh/measure my food. What is the rule for portion sizes in the mediterranean lifestyle? Sorry for all the questions, but thank you for your time!! I look forward to trying all your recipes.
Infants and patients fed via a gastrostomy tube can also be given a ketogenic diet. Parents make up a prescribed powdered formula, such as KetoCal, into a liquid feed.[18] Gastrostomy feeding avoids any issues with palatability, and bottle-fed infants readily accept the ketogenic formula.[30] Some studies have found this liquid feed to be more efficacious and associated with lower total cholesterol than a solid ketogenic diet.[3] KetoCal is a nutritionally complete food containing milk protein and is supplemented with amino acids, fat, carbohydrate, vitamins, minerals and trace elements. It is used to administer the 4:1 ratio classic ketogenic diet in children over one year. The formula is available in both 3:1 and 4:1 ratios, either unflavoured or in an artificially sweetened vanilla flavour and is suitable for tube or oral feeding.[50] Other formula products include KetoVolve[51] and Ketonia.[52] Alternatively, a liquid ketogenic diet may be produced by combining Ross Carbohydrate Free soy formula with Microlipid and Polycose.[52]

^ Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–63. doi:10.1542/peds.102.6.1358. PMID 9832569. https://web.archive.org/web/20040629224858/http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM Lay summary]—JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.
Hello Marylin, Yes, the Mediterranean diet has been shown to be effective for weight loss. However, you dip need to consume the right amounts of food (calories) to lose weight as that varies depending on age, gender activity level etc. Here is a link to the Greek Nutrition Guidelines that includes servings https://www.olivetomato.com/eat-like-greek-greek-dietary-guidelines-a-better-choice/
Two additional shortcuts that can easily be worked into a DASH diet plan are meal prepping and batch cooking—both of which are important for quick, healthy eating. Meal prepping doesn’t have to mean cooking a full meal, either. It’s just preparing components that can be used to toss together a quick meal—like baking chicken breasts, roasting vegetables, and cooking a whole grain like quinoa. You can also minimize time spent in the kitchen by buying weekly salad greens, bags of pre-cut veggies, and prepping produce at the start of the week.
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.
Although some studies have indicated that a ketogenic diet is associated with dyslipidemia (cholesterol and triglyceride perturbations), many of these results were obtained from studies on rodents and did not always agree with what the data show in human studies. A recent review summarized the controversy, highlighting the discrepancies in the literature. In part, the discordance is likely due to the exact composition of the diet, specific study design, as well as the metabolic differences between rodents and humans.
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.)
The plan promotes long-lasting, sustainable changes, and undoubtedly a bounty of research backs this up. In fact, one December 2013 study in the American Journal of Medicine shows that people following Weight Watchers were close to nine times more likely to lose 10 percent of their body weight, compared to people following a self-help diet plan. (20)

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I am in the uk and a diagnosed t2d. I am also a nurse, although I am in end of life care. Up until my diagnosis I am ashamed to say the I believed in exactly th.e same things as the writer of this article. Our health service actively promotes a carb rich diet for t2d. Not an excessive amount of calories, but a “healthy” amount of whole grains, fruit, whole rice etc. It was not until I did some actual research and looked at the science that I came to see that what I had been taught and what I really did believe to be the best advice was quite simply wrong.

WH verdict: It’s still a diet by any other name, but props to Weight Watchers for acknowledging that there’s more to being healthy than ‘weight’. The new platform really does consider all aspects of wellness. And with plans to partner with Alexa and Google Assistant to help track your progress, WW could be to 2019 what Weight Watchers was to the early noughties.

Yes, they're technically a fruit, but we think olives deserve a shout-out all of their own, since they're also a great source of healthy fats and are one of a few keto-approved packaged foods. Plus, they're a great source of antioxidants, will satisfy your craving for something salty, and are blissfully low-carb. “About a palm's worth only has 3 grams of net carbs,” Sarah Jadin, RD, told Health in a previous interview.


Dr. Reynolds reviewed numerous research studies on ketogenic diets,6 and he has found that most studies show that the drop in blood sugar is typically short-term—only lasting during the initial three months or so—but does not last.  "So it is very hard to encourage ketogenic diets when we have no evidence that they work over longer periods of time," he tells EndocrineWeb.
Upon starting the diet, some patients report symptoms like fatigue, headaches, and muscle aches. However, these short-lived symptoms are, in fact, a sign that the diet is working, and the body is switching over from burning glucose as fuel to burning fat. This transition involves upregulating certain enzymes and down-regulating others; it is a profound shift for the human body that can have uncomfortable symptoms. However, these side effect usually last only 3-4 weeks. They can be ameliorated in most cases, by drinking several cups of bouillion broth during the day until the transition is completed.15

I am a T2D, finally fully keto starting at the end of March. I am down 28 lbs. My goal is 50, so I am feeling encouraged and fitting into smaller sizes already. In May my A1C was 5.6. This morning, according to a home test kit I purchased from CVS, my A1C is 5. I believe that is fairly accurate based on my blood sugar readings, which are staying well below 100.


A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed; 24% occasionally prescribed the diet as a last resort; 24% had only prescribed the diet in a few rare cases; and 16% had never prescribed the diet. There are several possible explanations for this gap between evidence and clinical practice.[33] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[30]
The author wrote this out of angst because she failed at the ketogenic diet. It’s not a “hard” diet and you don’t have to give up all forms of desserts. You just have to learn to cook using stevia, almond or coconut flour instead of the white refined flours the author is addicted to. The information presented is false as well. The ketogenic diet has great benefits for the type two diabetic or prediabetic specifically.
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.
A systematic review in 2018 looked at sixteen studies on the ketogenic diet in adults. It concluded that the treatment was becoming more popular for that group of patients, that the efficacy in adults was similar to children, the side effects relatively mild. However, many patients gave up with the diet, for various reasons, and the quality of evidence inferior to studies on children. Health issues include high levels of low-density lipoprotein (LDL), high total cholesterol, and weight loss.[23]
Think of each almond as a natural weight-loss pill. A study of overweight and obese adults found that, combined with a calorie-restricted diet, consuming a little more than a quarter cup of the nuts can decrease weight more effectively than a snack comprised of complex carbohydrates and safflower oil—after just two weeks! (And after 24 weeks, those who ate the nuts experienced a 62% greater reduction in weight and BMI!) For optimal results, eat your daily serving before you hit the gym. A study printed in The Journal of the International Society of Sports Nutrition found that almonds, rich in the amino acid L-arginine, can actually help you burn more fat and carbs during workouts. Fill up, but don’t fill out: Use these Eat This, Not That!-recommended 10 Daily Habits That Blast Belly Fat.
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!
Obviously, if you could keep the weight off, it may help in preventing diabetes. There are many risk factors for diabetes, but the Diabetes Prevention Program in 2002 followed 1,079 people with prediabetes. This groundbreaking study showed that 58% were able to prevent the progression of developing diabetes through diet and exercise. Want to know what the great news is? They didn’t have to eat 20 carbohydrates per day to achieve this!

Shortly after World War II, Ancel Keys and colleagues (including Paul Dudley White, later President Eisenhower’s heart doctor) organized the remarkable Seven Countries Study to examine the hypothesis that Mediterranean-eating patterns contributed directly to improved health outcomes. This long-running study examined the health of almost thirteen thousand middle-aged men in the United States, Japan, Italy, Greece, the Netherlands, Finland, and then-Yugoslavia.

While the American Diabetes Association notes that many individuals with the disease or its precursor, prediabetes, employ carb counting to control their blood sugar on a regular basis, others have turned to ultra-low-carb diets as a way to manage their symptoms. These diets are highly restrictive and often limit followers to consuming no more than 20 grams (g) of carbs per day, usually with no added sugar, and, depending on the diet, increased protein and fat. Experts say they rarely have patients who ask about following a ketogenic diet or a modified paleo diet long term, but they can be useful for short-term weight loss if done properly.


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.
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