This is ALL so confusing and overwhelming. I am not diabetic. I am trying to be proactive about it. I am borderline obese (by US standards) and obese (by Asian standards). I am 50 years old. I was addicted to fat and sugar (especially combined!) through my teens and twenties. I decided to get healthy in my 30s, so I became a Vegan (but an unhealthy/careless one, so my weight yo-yo’ed a lot in my 20s and 30s). In my 40’s I reintroduced animal products into my diet and a number of my health issues went away, but I am still fat. I am considering Keto/Carnivore, but I am concerned that I may just be falling prey to more extreme diets which could set me up for problems (e.g. diabetes) down the road. I guess I am what most would refer to as pre-diabetic (metabolic syndrome). Should I try keto or am I taking too much of a risk?


I’ve been type 2 for about 15 years was pretty stable with diet and Metformin for 10 years. But eventually started trying more aggressive treatment like Victoza and without fail in 4 years I was on slow acting insulin. I lost weight lowered carb intake to 40mg or less in the morning my breakfast has been no carbs. People need to realize every diabetic is different you must manage it how it keeps you with good A1C levels. I myself got off insulin for a year and half but my fasting levels slowly increased again. Reversing diabetes is not possible. Reducing the effects is possible and more likely the better you monitor yourself and do what you need to do. Depending on medications or diets or counting carbs will all help but not cure the diabetes. These all are things that reduce its ability to affect your health negatively.
Recently, I had the chance to speak with the author of “The Mediterranean Diet Plan,” Susan Zogheib, a registered dietician about her diet plan. Susan will be joining me for an upcoming episode of HeartTalk presented by Capital Cardiology Associates this month (Sunday, June 24th). I wanted to share the highlights of conversation before YOU grocery shop this week so that you can discover the join of healthy eating this summer.
Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject.
Like a marathoner stretching before the big run, eating half a grapefruit before a meal can enhance your body’s fat-burning performance. A study published in the journal Metabolism found that this “warm-up” tactic can help whittle your middle—by up to an inch—in just six weeks! The scientists attribute the powerful effects to the grapefruits’ fat-zapping phytochemicals. The fruit can interact negatively with certain medications, so as long as you get the green-light from your M.D, plan to have half of a grapefruit before your morning meal and add a few segments your starter salads to reap the benefits.
The DASH diet often flies under the radar, especially when compared to buzzy diets such as the Keto diet, but it’s one of the most widely-respected diets out there. U.S. News & World Report has named it the “Best Diet Overall” for eight consecutive years in its annual diet rankings, and it’s recommended by the American Heart Association, who used it to develop their 2010 Dietary Guidelines.
Thank you for your wonderful comments Marcia. To share more about me personally with you all…I am not a completely non-diabetic Certified Diabetes Educator. I found out I had Prediabetes 15 years ago when I became a Diabetes Educator. I tested my own A1c and found it was 5.8%. The incredible news? There have been years when my A1c dropped to a normal level of 5.4%…out of the prediabetes range. My last A1c in May was 5.8%, so I still have Prediabetes 15 years later, but not diabetes, and without any medication, just the sensible diet I’ve discussed and exercise, so I really am living with this. I feel it everyday, I wonder what my A1c is going to be just like you every 6 months when I go to have it drawn.
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.
DASH stands for Dietary Approaches to Stop Hypertension. It’s a lifelong approach to eating that’s designed to prevent and treat high blood pressure, also called hypertension. It also falls in line with dietary recommendations to prevent osteoporosis, cancer, heart disease, stroke, and diabetes.  DASH encourages a variety of nutrient-rich foods while reducing the amount of sodium eaten. This eating plan includes plenty of fruits, vegetables, whole grains, low-fat dairy products, fish, poultry, legumes, nuts, and seeds.  Red meat and sweets are eaten in small amounts.
Yes!! Edward!! I am pre-diabetic myself and have IBS which many doctors have no explanation for many of my questions because IBS triggers everyone differently and with different foods. I have been keto for 6 weeks and have lost 14lbs and have not noticed any symptoms of IBS even when I eat trigger foods (onion/garlic) I am no means 100% keto yet because I have had slip ups here and there but I jump right back in. I can’t imagine not following this way of life moving forward. I immediately feel the difference if I indulge in anything more then I should. Im learning to listen to my body and now see carbs/sugar is what has been causing madness on my body. Keto-on Edward!
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]
Keep up electrolytes. The major electrolytes in our bodies are sodium, potassium and magnesium. Because a low carb diet (especially a keto diet!) reduces the amount of water you store, this can flush out electrolytes and make you feel sick (called “keto flu”). This is temporary, but you can avoid or eliminate it by salting your food liberally, drinking broth (especially bone broth), and eating pickled vegetables. Some people also choose to take supplements for electrolytes, but it’s best to first consult a doctor that understands and supports keto/low carb lifestyles.
U.S. News’s panel of experts noted that the Mediterranean Diet earned this year’s top spot because research suggests it can help improve longevity and ward off chronic disease. The Mediterranean Diet was also ranked No. 1 in several other categories: Easiest Diet to Follow, Best Diet for Healthy Living, and Best Diet for Diabetes. It also tied with the Ornish Diet for Best Diet for Heart Health.
At your favorite Greek restaurant, order lamb souvlaki. Have a bar-of-soap-size amount of lamb (or chicken if you prefer) and a baseball-size amount of couscous or rice. Go ahead and eat all of the vegetables that come with your order, and if there is a salad, top it with 1 tablespoon of dressing. Package up the remaining lamb and rice or couscous for Sunday's lunch. Serve with 1/2 glass (2 ounces) of wine.
Keep up electrolytes. The major electrolytes in our bodies are sodium, potassium and magnesium. Because a low carb diet (especially a keto diet!) reduces the amount of water you store, this can flush out electrolytes and make you feel sick (called “keto flu”). This is temporary, but you can avoid or eliminate it by salting your food liberally, drinking broth (especially bone broth), and eating pickled vegetables. Some people also choose to take supplements for electrolytes, but it’s best to first consult a doctor that understands and supports keto/low carb lifestyles.
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.
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 🙂
The more doctors test it, the more they find that eating Mediterranean is the absolute best way to lose weight. Based on the cooking and eating styles of Italy, France, Greece, Spain, and other Mediterranean countries, the plan features olive oil, fruits and vegetables, nuts, legumes, fish and poultry, whole grains and, yes, wine! It's high in heart-healthy fats and, unlike other diets, doesn't forbid any food group. "It's hard to stay on extreme diets," says Harvard nutrition expert Walter Willett, MD, PhD, whose book Eat, Drink, and Be Healthy popularized the approach in the United States. "This diet has lots of variety and wonderful flavors so people stick with it."
These carbohydrate recommendations are not PER DAY, they are per meal. This is the major difference between Ketogenic diets and a consistent, low carbohydrate diet CDEs advocate for. 30-45 carbs per meal is considered a low carb diet. Eating this in the form of a Mediterranean diet is what I recommend and what my article outlined. In a perfect world, we try to have people steer clear of anything artificial or processed when possible. Just eat fresh foods, like our grandparents did, who never had these types of health problems.
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.
Because this is an eating pattern – not a structured diet – you're on your own to figure out how many calories you should eat to lose or maintain your weight, what you'll do to stay active and how you'll shape your Mediterranean menu. The Mediterranean diet pyramid should help get you started. The pyramid emphasizes eating fruits, veggies, whole grains, beans, nuts, legumes, olive oil, and flavorful herbs and spices; fish and seafood at least a couple of times a week; and poultry, eggs, cheese and yogurt in moderation, while saving sweets and red meat for special occasions. Top it off with a splash of red wine (if you want), remember to stay physically active and you're set.
Ketones are frequently produced in healthy individuals–sometimes this is due to fasting (even just overnight), or as a result of eating a very low carbohydrate diet. With normal blood glucose levels, the ketone concentrations observed during ketosis are generally not harmful. The ketones are simply a byproduct of fatty acid metabolism, serving up an alternative energy source when glucose stores are low.

The truth is though, her reaction is part of the problem. “I can’t believe your numbers improved so drastically without taking the medication.” THAT is the main problem with our medical community. They have been taught, and most have bought into the lie, that everything is better with medication. Medication is the go to. That is why we have so many health issues in this country. Let’s eat a crappy diet because our government/medical community recommends it…and then when that diet leads to medical complications…let’s throw drugs/medication at it. Many, if not the majority, of the medical issues we have could be done away with if we actually ate as we should. But no…we want cake.
You have about 160,000 Kcals of fat available to burn – producing your own glucose in the process when needed (for anaerobic bursts). In contrast you only store around 400 to 500 Kcals of glucose/glycogen ready for use so if you are not adapted to burning fat then you are physically dependent and addicted to eating carbs. When you hear of a runner “hitting the wall” it’s only because of their unnatural carb addiction – an efficient fat burning athlete can run all day and will never have this problem. The human body is specifically designed to run long distance and can outrun almost every other animal on this planet – we can even run though intense heat because we sweat.
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 Mediterranean diet is easy to find in the grocery store, contains nutrients that are known to enhance longevity and has other health benefits that are backed by peer-reviewed, scientific studies. Broccoli makes the list because it's one of nature's most nutrient-dense foods, with only 30 calories per cup. That means you get a ton of hunger-curbing fiber and polyphenols -- antioxidants that detoxify cell-damaging chemicals in your body -- with each serving.
You start each day with a heart healthy breakfast. Your vegetable intake is increased. You find yourself making trips to the farmers market to get a better variety of fresh fruits and veggies. You stop eating processed food. And that’s a big one. Let’s talk about bread for example. Besides price and taste, what is the difference between white and whole grain bread?
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.
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.
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.
The researchers agree that the diet itself isn’t inherently dangerous. But, cautions Weiss, “If you have any medical condition, if you take any medicine at all – there are lots of things that change how medicines work in our bodies, and nutrition is definitely one of them. If you’re making a real change in your nutrition, you really should talk to your doctor.”
Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they might make it harder to stick to a keto diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.
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