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.
You should then transition to a normalized set of macros. While keto dieting can be good for short term fat loss, it’s important that it not brainwash you into thinking that certain foods or macros are “bad”. Eating a balanced diet with an understanding of your total daily energy expenditure (TDEE)  is the healthiest way to eat and the most sustainable way to lose weight long term.
Although you'll be cutting way back on carbohydrates and sugar, some fruits are still okay to eat on the keto diet (though you'll still want to be mindful about quantity in order to remain in ketosis). The fruits that make the cut contain far fewer carbs than their off-limits cousins such as apples, pears, bananas, pineapples, papayas, grapes, and fruit juices in general.
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]
– When eating the Mediterranean way, you’ll notice that we don’t eliminate any food groups. But we do rely more on vegetables, fruits, legumes and grains to supply more of what we eat. We also eat mostly lean proteins. So with that, if eating tempeh or other soy-based foods or if drinking green tea is something you enjoy, then that is up to you…and I would again encourage figuring that out with an RD or someone who can better assess your specific needs and advice you accordingly.

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”.

“We have basically no evidence that this diet is consistent with human health over time,” says Dr. Katz. (Its heavy emphasis on animal protein isn’t ecologically sustainable, either, he adds.) “All of the evidence we have points toward a plant-predominant diet with an emphasis on vegetables, whole grains, fruits, nuts, and seeds—all of the very things that the ketogenic diet avoids.”
1- Eliminate fast foods. For many of us living in America, this is one of the tougher adjustments and may take some time. To start with, try swapping a fast-food meal with a homemade one. For example, if it’s chicken wings you crave, make them Greek-style like in this recipe! Or if it’s sweet potato fries (my personal guilty pleasure), try baking them in olive oil with a sprinkle of Mediterranean spices like in this recipe. And So on!

There is research that supports the ketogenic diet for diabetes management, while other research seems to recommend opposing dietary treatments like a plant-based diet. Research from 2017 confirms that people with diabetes who followed a plant-based diet experienced significant improvements in blood sugars and A1c, cardiovascular disease risk factors, gut bacteria that is responsible for insulin sensitivity, and inflammatory markers like c-reactive protein.


One thing you’ll find people love about the Mediterranean diet is the allowance of moderate amounts of red wine. “Moderate” means 5 ounces (oz) or less each day for women (one glass) and no more than 10 oz daily for men (two glasses). (1) Above all else, these meals are eaten in the company of friends and family; strong social ties are a cornerstone of healthful lives — and a healthful diet. Here, food is celebrated.
My husband and I have lost weight after just 2 weeks on this. Not a lot, but enough to lose a belt loop. I've been menopausal for years, along with having an underactive thyroid, and losing weight has been almost impossible for me for the last few years. I'm unable to exercise much due to torn ligaments in my foot. Following this weight loss solution really helped. I'm going to get the other book with more recipes. Cutting out breads and sugar really did make a difference!

Sesame seeds likely aren’t one of those foods you pay any mind to, but the crunchy little buggers have been shown to play a crucial role in weight maintenance and deserve to be tossed into a salad or whole wheat noodle dish. Researchers suspect its the lignans—plant compounds—found in sesame seeds (and flax seeds) that makes them so special. In a 2015 study, women who consumed high levels of lignans tended to weigh less and gain less weight over time when compared to women who didn’t consume these compounds in high amounts.


Eat More Produce. Eating lots of low-calorie, high-volume fruits and vegetables crowds out other foods that are higher in fat and calories. Move the meat off the center of your plate and pile on the vegetables. Or try starting lunch or dinner with a vegetable salad or bowl of broth-based soup, suggests Barbara Rolls, PhD, author of The Volumetrics Eating Plan. The U.S. government's 2005 Dietary Guidelines suggest that adults get 7-13 cups of produce daily. Ward says that's not really so difficult: "Stock your kitchen with plenty of fruits and vegetables and at every meal and snack, include a few servings," she says. "Your diet will be enriched with vitamins, minerals, phytonutrients, fiber, and if you fill up on super-nutritious produce, you won't be reaching for the cookie jar."
What the diet advocate says: ‘We are committed to always being the best weight management program on the planet, but now we’re putting our decades of knowledge and expertise in behavioral science to work for an even greater mission,’ says Mindy Grossman, President and Chief Executive Officer, WW. ‘We are becoming the world’s partner in wellness. No matter what your goal is – to lose weight, eat healthier, move more, develop a positive mind-set, or all of the above – we will deliver science-based solutions that fit into people’s lives.’

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.


Speaking of standout breakfast foods, Greek yogurt is another option worthy of the spotlight thanks to its high-protein content. Per study in the journal Appetite, researchers from the University of Missouri compared the satiety effects of high-, moderate-, and low-protein yogurts on women aged 24-28, and found Greek yogurt, with the highest protein content, to have the greatest effect. What’s more? Probiotics in items such as yogurt and fermented foods, like pickles and sauerkraut, help good bacteria in the gut process food more efficiently. Hello, weight loss! If you want to get even more protein in your yogurt, check out Icelandic yogurts, which can have two to three more grams of protein per serving compared to Greek.
As CDE’s, we individualize our recommendations for each of our patients. One person’s diet may not be appropriate for another person. For example, a six foot 6 inch tall man weighing 220 lbs of mainly muscle, who exercises 2 hours per day at the gym cannot have the same number of carbs per meal as a petite 5 foot 1 inch 75 year old lady who does not exercise.
4. Better eyesight. The diet could help stave off or prevent macular degeneration, the leading cause of vision loss after age 54. The condition, which affects more than 10 million Americans, destroys the part of your retina responsible for the clear central vision you need to read, drive, and recognize faces. A recent study linked eating fish and vegetables to a reduced risk of getting it early, and the omega-3 fatty acids in fish can lower the risk of the disease altogether. What's more, the lutein in green leafy vegetables cuts your chance of cataracts and boosts retinal health, says Dr. Willett.

I must tell you when looking at this link they say the American Diabetes Association Guidelines call for 60-75 carbohydrates per meal and that is simply not true. The ADA has recommended since 2013 we use our best clinical judgement in recommending a low carbohydrate diet for people with diabetes, recognizing it needs to be individualized. 60-75 grams is the carbohydrate amount I would give to a very tall, large boned man or perhaps an active teen or young adult. I would never recommend that many carbohydrates for an average size man who was trying to lose weight; he would get 45-60 grams of carbohydrates per meal and 15-30 grams for snacks. A women trying to lose weight would get 30-45 grams of carbohydrates per meal and 15 grams for snacks.

At first glance the ketogenic (keto) diet may seem like a crazy idea for type 2 diabetics. After all, many patients are put on diets to help them lose weight. The keto diet is high in fat, but it is very low in carbs, and this combination can help change the way your body stores and uses energy. With this diet your body converts fat instead of sugar into energy, which can improve blood glucose levels while reducing the need for insulin.
What the diet advocate says: ‘It essentially means scaling your carbohydrate intake up and down in accordance with your activity levels,’ explains performance nutritionist Liam Holmes (phnutrition.co.uk). He uses the principles of nutrient timing to get elite athletes and CrossFit enthusiasts to their leanest before competitions. ‘The body works harder when it doesn’t have carbs as fuel, so it learns to become a more efficient burner of the fuel once it is there.’
What a great post. I thought i would add about the selection of food you eat on keto and that everyone is different. Some food gives you energy and some doesnt, this varies person to person. I started and quit keto 3 times before i managed to find my balance. The first few times it made be poorly, from the shock of diet change. However, you can wean yourself into the diet which i did the last time when i had the most success.

All hail spinach, the original dark leafy green with a mega-dose of iron—one crucial nutrient responsible for maintaining strong energy levels. And don't forget to praise feta—this is one crumbly, savory cheese that's lower in fat and calories than most, meaning you can have more of it! Feta doesn't melt very easily, so try a blend of stringy mozzarella and feta for the perfect, light sandwich.

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.


Remember that on some days, you may eat a few more or a few less servings than recommended for a particular food group. That's generally OK, as long as the average of several days or a week is close to the recommendations. The exception is sodium. Try to stay within the daily limit for sodium as much as possible. Also note that the values for nutritional information may vary according to specific brands of ingredients you use or changes you make in meal preparation.

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).
In summary, the LCKD had positive effects on body weight, waist measurement, serum triglycerides, and glycemic control in a cohort of 21 participants with type 2 diabetes. Most impressive is that improvement in hemoglobin A1c was observed despite a small sample size and short duration of follow-up, and this improvement in glycemic control occurred while diabetes medications were reduced substantially in many participants. Future research must further examine the optimal medication adjustments, particularly for diabetes and diuretic agents, in order to avoid possible complications of hypoglycemia and dehydration. Because the LCKD can be very effective at lowering blood glucose, patients on diabetes medication who use this diet should be under close medical supervision or capable of adjusting their medication.
Meal planning also causes you to look at your calendar and consider everyones schedule. Grocery shopping can again become part of the family routine with everyone contributing to the meal. You’ll also notice a change in your weekly food budget. Susan pointed out that she had, “Given a presentation on the cost of buying food and cooking meals at home saved $1,200 a year versus eating out. Eating out on average costs people about $2,000 a year. Yes, there are some up front costs when buying the spices or equipment you may need but the second time you go to use them, you are saving instead of spending.”

WY conceived, designed, and coordinated the study; participated in data collection; performed statistical analysis; and drafted the manuscript. MF assisted with study design, performed data collection, and helped to draft the manuscript. AC analyzed the food records. MV assisted with study/intervention design and safety monitoring. EW participated in the conception and design of the study, and assisted with the statistical analysis. All authors read and approved the final manuscript.

It is important to understand that the statement that carbohydrates are “nonessential” is not only factually inaccurate, it results in adopting a low-carbohydrate diet or ketogenic diet that increases your risk for a wide variety of chronic health conditions that may ultimately shorten lifespan, decrease your quality of life, and accelerate your risk for chronic disease.
AND i’m losing weight! I’m losing about 1 lb per week and actually have the energy again to workout regularly. If you have diabetes, you know how fatiguing of a disease it can be. I feel less sluggish, more “awake”, just better in general, while restricting my carb intake. Yeah, I miss some fruits, but I sure as heck don’t miss what I felt like after eating them. Besides, berries are allowed on keto 🙂
You say keto is a highly controversial topic. For those of us following a keto diet, there is no controversy whatsoever because the diet proves itself efficacious very quickly. I think the real controversy comes in because the ADA has been recommending dangerous levels of carbs for decades now, and they would lose face if they had to change their recommendation and admit they’ve been wrong for so long. You say there are not many studies on the keto diet, and I disagree with you. You’ll find the evidence if you look for it. Eric Westman, Steve Phinney, Jeff Volek and many other researchers have written volumes about this.
Today, make half of this GH exclusive Mediterranean Grilled Sea Bass recipe and reserve half of that for Thursday lunch. Increase your vegetable intake by serving half a bag of baby arugula leaves with this meal (save the other half for Thursday). Serve with one ear of corn and 1 cup cooked sugar snap peas topped with 2 teaspoons trans-fat-free light margarine. For dessert, have one frozen fruit juice bar (limit 80 calories for the bar).
I must tell you when looking at this link they say the American Diabetes Association Guidelines call for 60-75 carbohydrates per meal and that is simply not true. The ADA has recommended since 2013 we use our best clinical judgement in recommending a low carbohydrate diet for people with diabetes, recognizing it needs to be individualized. 60-75 grams is the carbohydrate amount I would give to a very tall, large boned man or perhaps an active teen or young adult. I would never recommend that many carbohydrates for an average size man who was trying to lose weight; he would get 45-60 grams of carbohydrates per meal and 15-30 grams for snacks. A women trying to lose weight would get 30-45 grams of carbohydrates per meal and 15 grams for snacks.
For the ketogenic eating plan, participants were instructed to reduce non-fiber-containing carbohydrates to between 20 and 50 grams a day, with no calorie restriction. The group following the plate method were told to eat their meals on a nine-inch plate, filling half of it with non-starchy vegetables (eg, greens, peppers, broccoli, carrots), ¼ of the plate with whole grains (eg, brown rice, sweet potatoes, whole wheat bread) and adding lean protein (eg, skinless chicken, turkey, fish, and seafood) to the last quarter of the plate.1
Ranging from just-juice to just-tea cleanses, these typically short-term plans can be dangerous. “Detoxes and cleanses are usually low in calories, protein, and fiber, all nutrients that our bodies need to function,” says Alissa Rumsey, RD, who is in private practice in New York City. “These plans leave you feeling hungry and cranky, causing a rebound food binge once you stop the detox.”
The diet that brought ‘lectins’ into the mainstream - a plant-based protein found in the likes of legumes (lentils and beans), nightshade veg (tomatoes, potatoes and aubergine), eggs and grains. The man who popularised the lectin-free diet – Dr Steven Gundry – describes them as ‘toxic’. In his book that brought a lectin-free lifestyle to the masses – The Plant Paradox – he cites them as the source of modern ailments from obesity to gastrointestinal disorders.
Without peer-reviewed clinical trials, many of the benefits remain anecdotal. For instance, Weiss himself has been on a low-carb high-fat (though not strictly ketogenic) diet for more than six months, and claims he does feel much better. But he’s clear about what he knows and what he doesn’t. He’s lost weight and his borderline pre-diabetes is gone.  
If it all feels a little bit 90s, that’ll be because this was basically the diet that kept Rachel from Friends looking, well, like Rachel from Friends. Think of it as the 20th-century version of no carbs before Marbs. Thankfully though, the old premise of each as much as you want, as long as you don’t go near a carb, has had a makeover. The New Atkins diet reintroduces carbs in phases.
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.
After about two to seven days of following the keto diet, you go into something called ketosis, or the state your body enters when it doesn't have enough carbs for your cells to use for energy. That's when you start making ketones, or organic compounds that your bod then uses in place of those missing carbs. At this point, your body also starts burning fat for more energy, says Beth Warren, R.D., founder of Beth Warren Nutrition and author of Living A Real Life With Real Food.
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.
Not to be outdone, oolong tea—a Chinese beverage—can help those who drink it shed up to a pound per week. According to a study in the Chinese Journal of Integrative Medicine, participants who regularly sipped oolong tea lost six pounds over the course of six weeks. What’s more? The tea’s antioxidants are thought to remove harmful free radicals and improve bone health.

The primary outcome, hemoglobin A1c, decreased from 7.5 ± 1.4% at baseline to 6.3 ± 1.0% at week 16 (p < 0.001), a 1.2% absolute decrease and a 16% relative decrease (Table ​(Table4).4). All but two participants (n = 19 or 90%) had a decrease in hemoglobin A1c (Figure ​(Figure1).1). The absolute decrease in hemoglobin A1c was at least 1.0% in 11 (52%) participants. The relative decrease in hemoglobin A1c from baseline was greater than 10% in 14 (67%) participants, and greater than 20% in 6 (29%) participants. In regression analyses, the change in hemoglobin A1c was not predicted by the change in body weight, waist circumference, or percent body fat at 16 weeks (all p > 0.05).


Grains and beans are high in lectins, and it’s no surprise that the top allergen foods also have a high lectin content. The lectins in nightshade vegetables can be troublesome for some people, while others handle them just fine. Cooking and peeling removes some of the lectin content in vegetables (but not grains, they’re pretty heat stable), but some super-sensitive people have to avoid them completely.
Keto decreases inflammation and improves brain function — so much so that Alzheimer’s patients who switch to a keto diet actually begin to recover their brain function, which up until now was unheard of.[20][21][22][23][24] So there’s that. (Dale Bredesen and Mark Hyman have discussed these on the Bulletproof Radio podcast. Check out Dale’s episode here, and Mark’s here.)  
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.
Gary D. Foster, Ph.D., Holly R. Wyatt, M.D., James O. Hill, Ph.D., Brian G. McGuckin, Ed.M., Carrie Brill, B.S., B. Selma Mohammed, M.D., Ph.D., Philippe O. Szapary, M.D., Daniel J. Rader, M.D., Joel S. Edman, D.Sc., and Samuel Klein, M.D., “A Randomized Trial of a Low-Carbohydrate Diet for Obesity — NEJM,” N Engl J Med 2003; 348:2082- 2090. http://www.nejm.org/doi/full/10.1056/NEJMoa022207.
The other nutritional remedy for T2 diabetes is carbohydrate restriction. In a large, ongoing university-based study, 60% of patients with Type 2 diabetes reversed their diagnosis of diabetes after just one year on a ketogenic diet, supplemented by support via a mobile phone app.11 On this protocol, 94% of participants reduced or eliminated their need for insulin medications while improving the vast majority of cardiovascular risk factors.12
Now I have to say, I am not a supporter of rigid plans, however it is important to eat at somewhat regular times so you don’t end up feeling very-very hungry at any particularly moment of the day. Having said that, I also think it is important to be able to actually feel hunger, and look forward to eating a meal.  While adding a snack here and there is good to keep blood sugar and hunger levels in balance, snacking can also backfire. Many times we eat a snack without being hungry or we depend on ready-made snacks such as granola bars, juices, smoothies etc. which not only add quite a few calories but also are a processed food with all that entails.
The subjects had a mean BMI of 42.2, mean age of 56 years, and were of either African-American or Caucasian descent. In their intervention, subjects consumed a LCKD diet with the goal of eating less than 20 grams of carbohydrates per day while reducing dosages of diabetes medication. Subjects also received nutritional counseling and medication adjustment every two weeks.
From baseline to week 16, the mean body weight decreased significantly from 131.4 ± 18.3 kg to 122.7 ± 18.9 kg, BMI decreased from 42.2 ± 5.8 kg/m2 to 39.4 ± 6.0 kg/m2, and waist circumference from 130.0 ± 10.5 cm to 123.3 ± 11.3 cm (Table ​(Table3).3). The percent change in body weight was -6.6%. The mean percent body fat decreased from 40.4 ± 5.8% to 37.0 ± 6.0%. Systolic and diastolic blood pressures did not change significantly over the 16 weeks. The mean heart rate decreased from 81.2 ± 12.9 beats per minute to 74.6 ± 14.0 beats per minute (p = 0.01).

Note: Because you'll be excluding some major food groups on the keto diet (grains, many fruits) you should definitely think about taking a multivitamin—especially one that contains folic acid, which helps your body make new cells and is often found in enriched breads, cereals, and other grain products, says Julie Upton, R.D., cofounder of nutrition website Appetite for Health.
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